Referring Clinicians

Coordinate neuro-ophthalmology care

A focused referral guide for clinicians coordinating complex optic-nerve, visual-pathway, and eye-movement evaluations with our Encino office.

Call (818) 387-6565Review the Checklist

Before You Send Records

Call before sending records

There is no online referral form or records upload. Call our office to confirm urgency, scheduling, and which records to fax.

Do not send patient records through a website form.
Office phone(818) 387-6565Call before faxing records
Fax(818) 387-6288Use after confirming what to send

Referral Criteria

When neuro-ophthalmology consultation may help

A physician referral is not always required, but these are common reasons clinicians coordinate a focused evaluation.

  • Optic nerve swelling, optic neuropathy, or unexplained visual field loss
  • Persistent or unexplained double vision and abnormal eye movements
  • Suspected cranial nerve palsy, myasthenia gravis, or thyroid eye disease
  • Idiopathic intracranial hypertension or papilledema follow-up
  • Unexplained vision loss or a complex case needing a second opinion

The website and contact form do not replace emergency care. For sudden vision loss, severe eye pain, or stroke-like symptoms, call 911 or go to the nearest emergency department.

Clinician Guides

Five focused referral resources

Each guide below pairs referral signals with the records that make the consultation more useful. Emergency guidance takes priority over routine office coordination.

Records Checklist

What to have ready when you call

The office will confirm what is appropriate for the specific referral. Having these items identified helps avoid incomplete or duplicate workups.

  • The referral question and the most relevant recent clinical notes
  • Prior visual field and OCT reports, when available
  • Relevant imaging reports and access instructions for completed scans
  • A current medication list and pertinent medical or neurologic history
  • Insurance referral paperwork when the patient's plan requires it

Coordination

A direct phone-and-fax workflow

  1. Step 1

    Call the Encino office

    Share the referral question without using a public web form and ask what records are needed.

  2. Step 2

    Confirm urgency and paperwork

    The office can clarify scheduling, referral paperwork, and whether the situation belongs in routine or emergency care.

  3. Step 3

    Send the requested records

    Use fax (818) 387-6288 after confirming the relevant notes, testing, and imaging information with the office team.

Optic Disc Elevation

Papilledema vs. pseudopapilledema: urgency and records

Papilledema is true optic-disc swelling from elevated intracranial pressure and requires urgent investigation. Pseudopapilledema is an elevated-looking disc without true edema; distinguishing the two changes both urgency and workup.

Referral focus

  • State whether true papilledema is suspected, already diagnosed, or the disc has been labeled pseudopapilledema.
  • Document new headache, transient visual obscurations, pulsatile tinnitus, double vision, or vision loss.
  • Note whether the disc appearance, OCT, or visual field is new, progressive, or stable over time.

Include when available

  • Optic-disc photographs and examination findings, when available
  • OCT RNFL and visual field reports with dates for comparison
  • Completed brain or orbital imaging reports and access instructions
  • The ordering clinician's urgent imaging or emergency plan, if one is already underway

Urgency: New-onset papilledema should follow same-day emergency evaluation or the ordering clinician's urgent imaging plan; it should not wait for a routine outpatient request. A prior pseudopapilledema label should be revisited when new symptoms, disc changes, progressive field loss, or increasing OCT RNFL appear.

Physician-reviewed sourcePapilledemaUrgency, imaging, visual fields, OCT, and monitoring.Physician-reviewed sourcePseudopapilledemaDistinguishing features and longitudinal follow-up.

IIH

IIH monitoring and referral checklist

Idiopathic intracranial hypertension can damage the optic nerves when pressure-related papilledema is not monitored and treated. Visual fields, OCT, disc appearance, symptoms, and completed diagnostic studies give the referral its clinical timeline.

Referral focus

  • Identify whether IIH is suspected, newly diagnosed, under active treatment, or being referred for a second opinion.
  • Describe new or worsening visual blackouts, double vision, acuity change, field loss, or headache-pattern change.
  • State whether papilledema is present and whether vision or disc findings appear stable or progressive.

Include when available

  • Serial visual field reports and OCT studies with dates
  • Recent optic-disc examination findings or photographs
  • MRI/MRV and lumbar-puncture reports, including opening pressure when completed
  • Current medications and the existing monitoring or follow-up plan

Urgency: Clearly worsening vision, more frequent transient blackouts, new double vision, or severe papilledema warrants same-day emergency evaluation. Call 911 when vision symptoms occur with stroke signs, fainting, confusion, seizure, or a sudden severe headache.

Physician-reviewed sourceIdiopathic intracranial hypertensionDiagnostic workup, vision monitoring, and urgency.Physician-reviewed sourceIIH patient journeyDiagnosis through long-term monitoring and care.

Diplopia & Cranial Nerves

New diplopia and cranial-nerve-palsy urgency

New adult double vision requires prompt cause-finding. Whether it resolves when either eye is covered, the pupil and eyelid findings, associated neurologic symptoms, and the suspected cranial nerve all change triage and workup.

Referral focus

  • Record sudden versus gradual onset and whether covering either eye makes the doubling disappear.
  • Document pupil size and reaction, ptosis, eye position and movement, headache, weakness, speech change, or balance trouble.
  • For a known cranial nerve palsy, include onset, interval change, stability, and any completed emergency imaging.

Include when available

  • Eye-movement, alignment, pupil, and eyelid examination findings
  • Completed brain, orbital, or vascular imaging reports and access instructions
  • Relevant neurologic notes and medical history
  • Prior prism measurements or visual field testing when available

Urgency: Call 911 for sudden double vision with severe headache, a droopy lid and larger pupil, weakness, numbness, speech difficulty, trouble swallowing, imbalance, or recent head injury. A new third nerve palsy needs same-day emergency triage even when the pupil appears normal; outpatient neuro-ophthalmology is appropriate for ongoing management after the urgent workup.

Physician-reviewed sourceDouble visionMonocular versus binocular patterns and emergency signs.Physician-reviewed sourceThird nerve palsyPupil findings, vascular imaging, and follow-up.

Visually Triggered Dizziness

When a visual-vertigo referral adds value

Visual vertigo is dizziness provoked by visual motion or visually complex settings and often follows a vestibular disorder, migraine-related vertigo, concussion, whiplash, or another balance-system injury. Vestibular rehabilitation is the main treatment for most patients; eye or neuro-ophthalmology evaluation adds value when the pattern includes vision changes or a possible ocular or neurologic contributor.

Referral focus

  • Describe the visual triggers, symptom duration, functional impact, and the vestibular or neurologic event that preceded them.
  • Note persistent, worsening, or disabling symptoms, associated vision changes, or failure to improve with initial care.
  • Identify eye-movement abnormalities, optic-nerve concerns, field loss, or other findings suggesting unreliable visual input.

Include when available

  • Prior vestibular, neurologic, and eye evaluations
  • Completed eye-movement, vestibular, balance, or questionnaire-based testing
  • Visual field or brain/orbital imaging reports when already performed
  • Current medications and prior rehabilitation or treatment history

Urgency: Sudden vision loss, new neurologic symptoms, stroke-like symptoms, chest pain, or a severe new headache requires urgent emergency care rather than a routine referral.

Physician-reviewed sourceVisual vertigoTriggers, differential evaluation, and rehabilitation.

Referral Packet

Neuro-ophthalmology records and imaging checklist

A concise referral question plus dated, longitudinal testing helps the consulting clinician see what changed, what has already been excluded, and which decision the consultation needs to address.

Referral focus

  • Lead with the clinical question, symptom onset, trajectory, and current urgency.
  • Identify the working diagnosis, important alternatives, and what the consultation should clarify.
  • Call the office before sending records to confirm what is needed for that referral.

Include when available

  • Relevant recent ophthalmology, neurology, emergency, or primary-care notes
  • Dated visual fields, OCT reports, and optic-disc or retinal photographs
  • Imaging reports plus access instructions for completed MRI, CT, CTA, or MRA studies
  • Current medications, pertinent history, and required insurance referral paperwork

Urgency: The website and contact form do not replace emergency care. For sudden vision loss, severe eye pain, or stroke-like symptoms, call 911 or go to the nearest emergency department.

Physician-reviewed sourceOCT guideWhat optic-nerve and retinal OCT contributes.Physician-reviewed sourceVisual field testingHow field loss is mapped and followed over time.Physician-reviewed sourceMRI brain and orbitsWhat the imaging study is designed to evaluate.

Referral Coordination

Speak with the office before sending records

Call to discuss the referral question, required records, and scheduling. Do not send patient information through a website form.

Call (818) 387-6565Neuro-Ophthalmology Care