Central Serous Retinopathy: the new carpal tunnel for information workers

February 20, 2013

Is Central Serous Retinopathy (CSR) the new carpal tunnel for a generation of over-stressed and over-loaded information workers who spend far too many hours per day staring at screens of varying dimensions?

Central serous retinopathy (or choroidopathy) is essentially a delamination of the retina when cellular layers that normally serve as a fluid barrier between the choroid and the retina begin to leak. This introduces a bubble or blister of fluid underneath the retina. This results in blurred and dimmed vision.

Although CSR is idiopathic, it has been linked to chronic stress, defined biochemically as elevated serum cortisol levels. This finding is corroborated by an increased incidence of CSR in those with Cushing’s Syndrome (chronic overexposure to elevated levels of cortisol.) Men are more often affected than women; with an age of onset between 20-50, averaging around 45.

I’ve been having progressively worse vision problems since December that I had attributed to floaters or sleep deprivation. Given the sad state of my own personal health care coverage as a self-employeed worker and the prevalence of holidays and work deadlines around the turnover of a new year, I didn’t get around to checking this out until this week. After a standard eye exam, I was tentatively diagnosed with Central Serous Retinopathy (CSR), confirmed a few days later by fluoroscein angiography.

My symptoms currently include a large purplish gray blotch almost dead-center in my field of vision; completely distorted visual acuity that’s not just blurry but makes straight lines look broken and covered with Adobe’s marching ants from using the lasso tool; micropsia (things appear smaller than the unaffected eye); loss of several aspects of color perception; and — surprise — everything looks dim and desaturated.

I’m certainly not a high stress individual. I’m not Type-A; I don’t go around yelling at people. I am, however, a perfectionist, although I’ve softened in my old age. Now I’m satisfied if things are done as best as they possibly can be with the time and team available.

I do work hard and I work long hours and have been doing so for many years.

Here’s a brief outline of a typical day for me.

Wake up early, anytime between 3-4:30 am. Roll over and check the time on my phone. Check my email. Read about things I need to deal with and decide to just get up. Espresso. Since I’m a teleworker, lunch was almost always a working lunch at my desk. And without any seminars or Bits ‘n’ Nibbles to attend in the afternoon, I’d work straight through until 6, 7 or 8, with a full work day of 15, 16, or 17 hours. Multiply that times seven and I was typically logging close to 100 hours a week, each week, weekends and holidays inclusive.

So what am I doing to change? First off, I’m no longer tethered to my phone. If I’m not working, I’m not answering work emails. I’m waiting until I’m actually at my desk to start working. And I’m making every effort to reclaim my weekends and holidays and not working at all. And I’m keeping my fingers crossed I retain my vision.

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