A patient presents with diplopia with limitations of adduction in the left eye and abducting saccade in the right eye. Convergence is preserved. Most likely etiology is -
Internuclear ophthalmoplegia. In this condition, there is lesion in the medial longitudinal fasiculus (MLF). There is defective action of medial rectus on the side of lesion. Medial rectus causes adduction of the eye on same side. Contraction of right lateral rectus and left medial rectus causes Dextroversion whereas contraction of left lateral rectus and right medial rectus causes Levoversion. Horizontal nystagmus of opposite convergence is normal. Ref; A.K.Khurana;6th Edition; Page no: 355
Paial 3rd nerve palsy
lnternuclear ophthalmoplegia
Duane's reactionary syndrome
Absence of medial rectus muscle
Ocular motility and squint