A diagnosis of neuromyelitis optica is based on a physical examination; identification of characteristic signs and symptoms; and a variety of specialized imaging and laboratory tests. For example, magnetic resonance imaging (MRI scan) or computed tomography (CT scan) of the brain and spinal cord and optical coherence tomography (specialized pictures of the retina) can be used to locate areas of nerve damage. Special blood tests that are used to detect autoimmune conditions and/or examination of the cerebrospinal fluid may also be necessary to confirm a diagnosis.