Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system with various neurological and ocular manifestations. Ocular involvement occurs in approximately 80% of patients sometime during the course of the illness, and may be the presenting sign in about 50% of the patients with this disease. Bilateral internuclear ophthalmoplegia (BINO) is a common ocular complication of MS, occurring in up to one third of all MS patients. BINO is an ocular motility impairment characterized by a total or partial inability to adduct each eye accompanied by a concomitant nystagmus of the abducting eye on lateral gaze and a vertical gaze-evoked nystagmus. The importance of using an interdisciplinary approach to properly diagnose and manage MS will be discussed with a case review of a 57 year-old patient with BINO.


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