Central serous retinopathy (CSR) is a condition where fluid builds up behind the retina.1 The fluid comes from a leak in a layer of tissue behind the retina called the choroid, which collects under the macula (the central part of the retina). This causes swelling and a small ‘detachment’.1 This detachment can lead to a variety of symptoms.
Symptoms of CSR
The symptoms of central serous retinopathy can make it difficult to perform everyday activities, such as reading, driving, and working on a computer. Symptoms include:
- Dimmed or blurry vision
- Objects appearing further away than they actually are
- Colours appearing duller
- White objects looking like they have a brown tinge1
Blurry vision is a common symptom of CSR because the condition often affects the macula, the central part of the retina responsible for sharp, straight-ahead vision. As fluid builds up underneath the macula, it can create a small, blister-like swelling which separates it from the retina.1 If the fluid builds up underneath the macula, you could experience blurred vision when doing things like reading, or using your smartphone — this is because the macula is responsible for distinguishing fine details.2
Usually, only one eye is affected, although both eyes can be involved. If you notice any differences in your vision generally, book an appointment with your optician.
Does having blurry vision whilst I am stressed mean I have CSR?
While stress is a significant risk factor for CSR, if you have blurry vision and stress, these can also be signs of a variety of different conditions, and may not be related at all. In most cases, the cause of central serous retinopathy is unknown, but experiencing both blurry vision and stress has been linked to the condition. This is because of the stress hormone, cortisol.5 It’s worth noting that stress is not the sole culprit of CSR, and there are multiple factors involved.5
One of the best ways to know whether blurry vision and stress are signs of CSR is to get an OCT scan.
What causes central serous retinopathy?
One major cause of CSR is stress. During periods of stress, the body releases a hormone called cortisol. This makes blood vessels more permeable and fragile. As a result, this can increase the likelihood of fluids seeping from blood vessels into the eye, which is why people who are under a lot of stress are more at risk of developing CSR.1 In some cases, no cause can be found to explain why the condition occurred.
Who is at risk of CSR?
According to Moorfields Eye Hospital, in London, middle-aged men in their 30s to 50s are listed as a primary risk factor for CSR, alongside2
- Treatment with steroid medications (such as asthma inhalers, nasal sprays and even steroid creams)
- Genetic risks
- Type A personality (competitive behaviour, stressed and those who find it hard to relax)
Other causes also include:
- Sleep disturbances like insomnia or sleep apnoea
- Autoimmune diseases
- Diabetic eye disease3
- Cushing’s syndrome
Is central serous retinopathy serious?
Central serous retinopathy causes vision problems but does not typically lead to diseases or complications beyond these.
For some people, central serous retinopathy can lead to permanent central vision loss if the fluid underneath the macula does not resolve, however, this is in rare cases. Some treatments for CSR may cause scarring, which can lead to impaired vision.
How is central serous retinopathy diagnosed?
If you are experiencing any symptoms, book an appointment as soon as possible with your eye doctor. An optometrist can examine the retina and provide further information on the condition of the eye. Usually, some tests and procedures are run to diagnose the condition. These include ocular coherence tomography (OCT).
Can OCT scans help to detect CSR?
Ocular coherence tomography (OCT) is a quick imaging test that allows an optometrist to see a detailed picture of each layer in the eye. In people with central serous retinopathy, this test can show if and where fluid has built up in the retinal layers.2
OCT can image each distinct layer of the retina separately. This makes it possible to identify any abnormalities in any given layer of the retina. The optometrist can also detect and quantify the specific type of retinal detachment that is a hallmark of central serous retinopathy.
When to book at OCT scan
If you are experiencing blurry vision in times of stress, it’s important to see your optometrist, who may decide to book an OCT scan for you based on your symptoms and history.
Central serous retinopathy typically improves in four to six months without treatment.6 However, if the condition is longstanding or episodes of CSR keep recurring, it can lead to permanent visual changes — which is why you should never ignore symptoms such as blurry vision and stress.5
Treatment for Central Serous Retinopathy
More often than not, no treatment is required for CSR. Instead, an optometrist or eye doctor will monitor the affected eye and ensure the fluid is being drained correctly. No other intervention will take place — it should resolve itself.
In rare cases, your eye doctor may recommend treatment to prevent more fluid leaking from the blood vessels behind the eye. Treatment for CSR consists of laser treatment and is only recommended if the condition fails to clear on its own.
How long does it take for central serous retinopathy to heal?
In most cases, CSR will resolve on its own without treatment. Vision is usually fully restored within four to six months.7
1. American Academy of Ophthalmology. (no date). What is central serous chorioretinopathy? [Online]. Available at: https://www.aao.org/eye-health/diseases/what-is-central-serous-retinopathy [Accessed 23 November 2019].
2. Moorfields Eye Hospital NHS Foundation Trust Patient Information. (no date) Central Serous Chorioretinopathy (CSCR). Available at: https://www.moorfields.nhs.uk/sites/default/files/Central%20serous%20chorio-retinopathy%20%28CSCR%29.pdf [Accessed 21 Jan. 2020]
3. British Journal of Opthalmology. (2019). Risk Factors For Incident Central Serous Retinopathy. 103:1784-1788. Zhou M, Bakri SJ, Pershing S.
4. Asrs.org. (2016). Central Serous Chorioretinopathy - The American Society of Retina Specialists. [online] Available at: https://www.asrs.org/patients/. [Accessed 18 Dec. 2019].
5. RNIB. (no date). Central serous retinopathy (CSR). [Online]. Available at: https://www.rnib.org.uk/eye-health/eye-conditions/central-serous-retinopathy [Accessed 23 November 2019].
6. Cochrane Database Of Systematic Reviews. (2015). Interventions for central serous chorioretinopathy: a network meta-analysis. Available at: https://www.cochrane.org/CD011841/EYES_interventions-central-serous-chorioretinopathy [Accessed 21 Jan. 2020]
7. Royal National Institute of Blind People (2021). Central Serous Retinopathy. Available at: https://www.rnib.org.uk/eye-health/eye-conditions/central-serous-retinopathy [Accessed 21 Nov. 2020]