Isolated medial rectus palsy in an otherwise healthy person is a very rare entity. It can be due to viral infections,
orbital myositis, orbital cysticercosis or due to small fne infarcts in midbrain involving lateral subnuclei of the
midbrain.These are the two case reports,one otherwise young adult female presented with sudden onset of blurring
vision with diplopia,abnormal head posture and pain with deviation of left eye and other a congenital case of 3
year female child patient with deviation of left eye and abnormal head posture.Typical or atypical inter nuclear
ophthalmoplegia should be ruled out after thorough clinical evaluation before making a diagnosis of isolated
medial rectus palsy.Isolated medial rectus palsy in an young patient may be masking a systemic disorder and
needs to be evaluated thoughrily.

Keywords: Isolated medial rectus palsy; Mid-brain infarct; Medial longitudinal fasciculus; Internuclear
ophthalmoplegia; Ocular tilt reaction.