Blurry vision can be a symptom of a variety of different conditions. When stress is involved, certain eye conditions can occur more frequently as a result. One of those conditions is called central serous retinopathy (also known as central serous chorioretinopathy).

Here, we describe what the condition is, why it can occur more commonly in people affected by stress, and its link to blurry vision. 

What is central serous retinopathy?

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 can lead to symptoms such as:

  • Dimmed or blurry vision
  • Objects appearing further away than they actually are
  • Colours appearing duller
  • White objects looking like they have a brown tinge1 

Usually, only one eye is affected, although both eyes can be involved. 

The symptoms of central serous retinopathy can obviously make it difficult to perform everyday activities, such as reading, driving, and working on a computer. If you notice any differences in your vision generally, book an appointment with your optician.

Can stress cause central serous retinopathy?

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. 

According to Moorfields Eye Hospital, in London, middle-aged men in their 30s to 50s are listed as a primary risk factor for CSR, alongside:2

  • Treatment with steroid medications (such as asthma inhalers, nasal sprays and even steroid creams)
  • Stress
  • Genetic risk
  • Type A personality (competitive behaviour, stressed and those who find it hard to relax)

Other risks also include1:

  • Sleep disturbances like insomnia or sleep apnoea
  • Autoimmune diseases
  • Diabetic eye disease3
  • Cushing’s syndrome 

Blurry vision and central serous retinopathy

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 smart phone— this is because the macula is responsible for distinguishing fine details. 

Sometimes, fluid does not build up under the macula, and if this is the case, you may not experience any blurred vision at all.4 An optometrist will need to examine your eye, in either case, to identify whether you have central serous retinopathy.

Does having blurry vision and stress mean I have central serous retinopathy?

While you should be aware of 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. 

How can OCT detect central serous retinopathy?

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.

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 an 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 4-6 months without treatment6. 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

Learn more about the testing and diagnosis of various conditions on our OCT resource or book an appointment with an optometrist if you notice any symptoms. 

Alternatively, if you’re unsure about your symptoms or would like some more information before booking, you can use our RemoteCare service for a free consultation via phone or video call.

References

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]