COVID-19: Learn the precautions Scripps is taking for safe, in-person visits Learn more

Neuro-Ophthalmology

Eye care for neurological vision problems in San Diego

A neuro-ophthalmologist checks a patient's eyes with a penlight, representing the combination of neurology and ophthalmology at Scripps in San Diego.

Eye care for neurological vision problems in San Diego

Because the relationship between the brain and the eyes is so complex, neuro-ophthalmological conditions require experts who can examine a patient’s history, symptoms, test results and other information to find a precise diagnosis.


Scripps has some of the most experienced neuro-ophthalmologists in San Diego. Our specialists carefully examine each patient, determine what is causing the eye problem, and develop a comprehensive treatment plan.


In addition, Scripps offers a wide range of referral options, including traditional ophthalmologists, neurologists, headache specialists and other specialists who can help you find relief from your specific symptoms.

What is neuro-ophthalmology?

Many vision disorders, such as cataracts and glaucoma, begin in the eye. But some vision issues may stem from an underlying neurological condition. That means rather than being caused by a defect in the lens or retina in the eye, the problem may actually start in the brain. Neuro-ophthalmology looks at both possibilities, combining neurology and ophthalmology to find the underlying conditions that can cause many vision issues.

Symptoms evaluated by a neuro-ophthalmologist

Neuro-ophthalmologic problems may cause a variety of symptoms, including:

Double vision

Double vision happens when a person literally sees double: two images appear when there is only one. It can affect one or both eyes, and the images may appear to be side by side or one above the other. 


Possible causes of double vision include cataracts, problems with the eye muscles or nerve, or brain-related conditions, such as stroke, aneurysm, migraine headache or tumor. Depending on each patient’s symptoms, diagnostic tests may include blood tests and imaging exams.

Episodic loss of vision

Also called episodic blindness, episodic loss of vision refers to sudden, temporary vision loss caused by lack of blood flow to the retina. Vision loss may be partial or complete, may affect one or both eyes, and may last from a few seconds to a few minutes. 


Episodic vision loss may be caused by a blood clot or piece of plaque that forms in a larger artery in the body and travels to an artery in the eye. Other causes may include migraine headache, blood vessel disease, inflammation of the optic nerve or brain tumor. The underlying cause may be diagnosed through blood tests, imaging exams and other tests.

Droopy eyelid

Also known as ptosis, a drooping eyelid is when the upper lid of the eye drops lower than normal. It may affect one or both eyes and may interfere with vision. While drooping eyelids are often a harmless sign of aging, they also may indicate an underlying health problem with the eye muscles, nerves or brain. 


Ptosis is more likely to be a sign of a serious problem if it develops quickly, over a few days or hours, than if it happens gradually over several years. Also, serious causes of ptosis often have other symptoms, such as double vision, weakness or problems speaking or breathing. In addition to an eye exam, diagnostic tests may include blood tests, imaging exams and others.

Dilated pupil (mydriasis)

The dark round center of your eye (pupil) is called dilated when it’s larger than normal. Your pupils normally dilate in low light, which allows more light into your eyes to help you see better. 


Mydriasis is when the pupils dilate for other reasons. These may range from medications and hormonal changes to serious conditions, such as stroke, brain injury and damage to the cranial nerve. Because dilated pupils increase sensitivity to light, they may cause blurred vision, headaches, dizziness and eye irritation. An ophthalmologist will examine the eyes to determine the cause and will work with the appropriate medical professionals to plan treatment.

Eye pain

Eye pain may include a variety of symptoms, including burning, throbbing, aching, sharp pain or general irritation ranging from mildly uncomfortable to very painful. A scratched cornea, infection or sinusitis are common eye pain causes that generally are simple to treat. 


Other causes of eye pain may indicate a more complex underlying condition, such as an immune condition or neurological condition with vision symptoms. Migraine or cluster headaches often lead to pain around the eyes. Conditions that affect the optic nerve, such as glaucoma and optic neuritis, can also cause eye pain. If the cause is neurological, the neuro-ophthalmologist will collaborate with the right specialists to determine the best treatment.

Hallucinations

Visual hallucinations happen when you think you see something that isn’t really there. Medications and high fevers may cause hallucinations, or there may be an underlying medical condition. 


Medical reasons for visual hallucinations may include Alzheimer’s disease and other types of dementia, epilepsy, Parkinson’s disease, tumors that affect the part of the brain that controls vision and Creutzfeldt-Jakob disease (CJD). A neuro-ophthalmologist can help determine what’s causing hallucinations and work with other specialists to diagnose and treat the condition. 

Migraine aura and vision problems

Some people who have migraine headaches experience visual symptoms called auras. Auras affect the brain’s visual cortex and interfere with normal vision. Auras may look like zigzag lines, geometric patterns or flashes of light that may move around or increase in size. Some people also lose part of their vision during a migraine aura. Typically, auras last about 15 to 30 minutes. 


Because migraine is related to the brain, a neuro-ophthalmologist and neurologist often work together to diagnose and treat this condition. Learn more about migraine treatment and take the migraine disability test.

Neuro-ophthalmology treatment at Scripps

We understand that vision problems can be frustrating and concerning, and we take a personalized, compassionate approach to neuro-ophthalmologic care. 


Whether your vision problems start in your eye, brain or elsewhere, our neuro-ophthalmology team can help identify the cause. We collaborate with experts in neurology, ophthalmology, rheumatology and other specialties to provide advanced diagnostic technology and comprehensive treatment options. We’ll provide the best possible care to help you see normally again.

Neuro-ophthalmology locations

Find a Scripps neuro-ophthalmologist at these locations:



View all locations for eye care at Scripps.