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TO THE EDITOR.— Unilateral internuclear ophthalmoplegia (INO) is a rare cause of diplopia in systemic lupus erythematosus (SLE) and implies a unilateral lesion of the medial longitudinal fasciculus (MLF). Each of the two previously reported cases1,2 had fulminant, widely disseminated SLE that resulted in death shortly after appearance of ocular symptoms. We recently encountered a patient with long-standing but mild SLE who developed a unilateral internuclear lesion.A 49-year-old woman was admitted for diarrhea that resolved without specific therapy during her hospitalization. She reported a 32-year history of episodic, migratory swelling and pain of large and small joints and had developed Raynaud phenomenon ten years before admission. Chronic staphylococcal abscesses had affected her for four years but eventually resolved. She had no other history of symptoms suggestive of SLE.Physical examination revealed a normotensive woman with telangiectasias on her fingertips, nose, and lower lip. The skin over her fingers was shiny