• Reference Number: HEY1581/2025
• Departments: Ophthalmology Department
• Last Updated: 31 May 2025

Introduction

This leaflet is designed to give you general information about your condition. It should answer most of your questions, but it is not meant to replace a conversation with your healthcare team. Instead, it can be a helpful starting point for discussion. If you have any further questions after reading it, please speak to a member of the healthcare team.

What is a Central Serous Retinopathy (CSR)

Central Serous Retinopathy (CSR) – also known as Central Serous Chorioretinopathy (CSC) – is a condition that affects the retina, particularly the central part of your vision. The retina is the light-sensitive tissue at the back of your eye, and its central area, called the macula, is responsible for sharp, detailed vision used for tasks like reading, driving, and recognising faces.

In CSR, fluid leaks from a layer of blood vessels underneath the retina (called the choroid) and collects beneath the retina itself. This causes a small, blister-like swelling that can make your central vision appear distorted or blurry.

Although CSR usually isn’t painful, it can interfere with daily activities and affect your quality of life.

What are the symptoms?

The symptoms vary from person to person but often include:

Vision Changes

• Blurred central vision – Words on a page or faces may appear fuzzy.
• Distorted vision (metamorphopsia) – Straight lines (like door frames or text) may look wavy or bent.
• A dark or grey spot in the centre of your vision.
• Objects appearing smaller or farther away than they really are (micropsia).

Colour and Light Sensitivity

• Colours may seem less bright or washed out.
• Difficulty seeing in low light.
• Glare or light sensitivity – Bright lights may feel uncomfortable.

Fluctuating Vision

• Some days, vision may be better or worse for no clear reason.
• Symptoms may worsen with stress or fatigue.

What causes CSR?

The exact cause is unknown, but several risk factors are linked to CSR:

1. Stress and Personality Type

• People who are highly driven, competitive, or stressed (sometimes called “Type A” personalities) are more likely to develop CSR.
• Major life stress (e.g., work pressure, personal crises) can trigger an episode.

2. Steroid Use

• Any form of steroids (tablets, inhalers, creams, or injections) increases the risk.
• Natural steroid hormones (like in Cushing’s syndrome) can also contribute to causing CSR.

3. Other Medical Conditions

• High blood pressure (hypertension)
• Sleep apnoea (breathing interruptions during sleep)
• Helicobacter pylori infection (a stomach bacteria linked to acid reflux)
• Pregnancy (due to hormonal changes)

4. Lifestyle Factors

• Smoking
• Excessive alcohol or caffeine
• Poor sleep habits

How is it diagnosed?

Your doctor will perform some tests to make the diagnosis.

1. Eye Examination

• You will have eye drops to dilate your pupil in order to get a clear view of the retina.
• The doctor will check for fluid buildup and rule out other eye conditions.

2. Optical Coherence Tomography (OCT) Scan

• A quick, painless scan that takes detailed cross-section images of the retina.
• It shows accurately where fluid is leaking and how much damage has occurred.

3. Fluorescein Angiography (FA) or ICG Angiography (if needed)

• A dye test where a special dye is injected into your arm.
• A camera tracks the dye as it flows through the blood vessels in your retina, highlighting leakage from the blood vessels.
• Not everyone needs this test. If your doctor thinks you need this test, it will be explained to you during the consultation.

How is CSR treated

1. Observation (Wait-and-See Approach)

• Most cases (85%) improve on their own within 3 to 6 months.
• Your doctor may recommend regular check-ups to monitor progress.

2. Lifestyle Changes

• Reduce stress – Try relaxation techniques (yoga, meditation).
• Improve sleep – Aim for 7 to 9 hours per night.
• Avoid steroids (if possible, under medical supervision).
• Try to quit smoking & limit alcohol/caffeine.

3. Medical Treatment (For Severe or Long-Lasting Cases)

Medical treatment is reserved for some cases which have lasted more than six months.

1. Photodynamic Therapy (PDT)

• A “cold laser” treatment combined with a light-sensitive dye.
• It helps to seal the leaking blood vessels without damaging the retina.
• Individual funding needs to be arranged for this treatment before it can be given. Your doctor will explain this to you if you meet the criteria to potentially benefit from this treatment.
• Side effects: Rare but may include temporary vision changes.

Other treatments, including standard laser, micro pulse laser, and medications (Eplerenone/ Spironolactone) unfortunately have not been shown to be effective in research studies and are, therefore, not recommended.

How Quickly will my vision improve

The way CSR may progress can be grouped into three categories:

1. Most people will recover within three to six months without any treatment.
2. CSR which last more than six months may require treatment to prevent structural damage at the back of the eye due to prolonged swelling. That is why CSR lasting more than 6 months may require treatment.

There is a small chance of your eye developing secondary complications due to CSR which is not settling:

1. Wear and tear damage to the centre part of the retina, which may cause permanent blurring of the central vision (macular degeneration)
2. Abnormal blood vessels growing through an area of wear and tear damage, which can cause new/worsening leakage or bleeding in the centre part of the retina (choroidal neovascularisation), which can cause the vision to suddenly worsen. This is a treatable condition if caught early. You will be given advise on how to seek help if you suddenly develop new symptoms

Around 40% of patients may have a recurrence of CSR at some point, and around 20% of patients may develop CSR in the other eye.

Living with CSCR

Driving and Work

• If only one eye is affected, you may still drive if your other eye meets DVLA standards.
• Check with your doctor before driving, especially if vision is very blurred.
• If your job requires sharp vision (e.g., driving, machinery), discuss adjustments with your employer.

Glasses and Vision Aids

• New glasses won’t fix CSR—your prescription may change as fluid clears.
• Low vision aids (magnifiers, screen readers) can help if vision loss persists.

Emotional Support

• Vision changes can be frustrating or worrying.
• Support groups (like the Macular Society/Eye Clinic Liaison Officer ECLO) offer advice and reassurance.

When to seek help

Please seek help if you notice any of the following:

• Symptoms worsen or don’t improve after 6 months.
• You notice sudden new changes in your vision (could

**Should you notice any sudden change or require further information, please do not hesitate to contact the Ophthalmology Department tel: 01482 816658 or tel: 01482 608788 (08:30 am to 17:00 pm;  Monday to Friday)**

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.