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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{ 5 comments… read them below or add one }

1 Penn Young August 11, 2013 at 10:07 pm

Hello,

I was just Dx w CSR last Wednesday and I have been obsessively reading and researching about the disease and prognosis online. I am currently under the care of a retina specialist and my treatment is to simply wait for self-resolution. I was advised to decrease my stress levels as well.

I was wondering how you were doing and if you had experienced (in addition to your mentioned symptoms) night vision deficit ( or almost night vision loss) , and how you were today. I hope you are well.

Thank you.

Penn

2 Rachel September 7, 2013 at 1:10 pm

…6 months later – how is your CSR? I’m in the same boat, so just curious about your progress. Mine has been hanging on for some more than the “3-6 months”. More like 1.5 years. Finally just in the past couple days, my ‘red ring’ when lights hit it just right, is all but gone. I’m trying to not get excited and jinx it (or scare it away. Ha.)
I’ve read that treatment should be sought if it lasts longer than 6 months. Not one to enjoy confirmed bad news, I haven’t talked to my eye doc since diagnosed…but maybe with the disappearance of the grey blob, I’ll give a call and hear some good news…
Happy weekend!

3 jean January 21, 2014 at 11:08 am

My son was diagnosed with CSR about 3 years ago. He is almost blind in one eye because of scaring from the bleeding and the other eye is also effected. I am looking now to see if anything is new in its care.

4 Deb April 2, 2014 at 6:29 pm

Has it recurred?

5 tharris April 2, 2014 at 7:15 pm

Unfortunately, yes. Going in Friday to have it checked again.

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