The authors present the case of a 5-year-old boy who developed a unilateral internuclear ophthalmoplegia (INO) following mild head trauma with supporting magnetic resonance imaging (MRI) findings of damage to the medial longitudinal fasciculus. At 2 months of follow-up, the patient had resolution of diplopia and only minimal residual nystagmus. Although rare in the children, INO can develop following head trauma. Management should include work-up to exclude etiologies beyond trauma (specifically with MRI, which is superior to computed tomography imaging in evaluating INO) followed by observation and, if needed, comanagement of any amblyogenic potential from ocular misalignment. .
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