This review summarizes the major neuro-ophthalmologic manifestations of epilepsy. Positive or negative visual manifestations such as hallucinations or visual loss may be seen. There is considerable overlap of the visual manifestations with migrainous aura and transient ischemic attack (TIA), making a detailed history important for accurate diagnosis. Oculomotor manifestations, such as tonic eye deviation, are often recognized to have localizing value. Nystagmus or repetitive blinking may be present and offer clues in clinically subtle seizures.