Central Serous Retinopathy: the new carpal tunnel for information workers

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.


  1. Penn Young says


    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.


  2. Rachel says

    …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 says

    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. says

    i had this problem, undiagnosed properly though, years ago in 1995. no meds were working to improve my vision. buck then I was a student, taking a social work course with extensive focus on stress – what high levels of cortisol could do to the organs. to my surprise long hours of fixed position of your body fells into category of putting your body on high stress, and it doesn’t matter if the environment when it happens is peaceful. fixed position of eyes or not much diversify movement is probably the cause. introducing frequent activities that forced my eyes to change focus to long-short-long-short and turn eyeballs into different directions like swimming and skiing helped. at least this is what i think it helped me to heal, after four months.
    there is no harm to try it, hope it helps somebody. sending best vibes!

    • Todd Harris says

      Marzzzena – Thanks for your suggestion! It makes sense to me.

      CSR is such a “black box”. It’s always good to hear what has worked for people and sadly, what hasn’t.

    • Todd Harris says

      I’ve had three or four more episodes since the first occurrence. I’m getting used to it. The onset is rapid. I usually notice when I’m staring at a blank wall, not that I sit around staring at blank walls often.

      Resolution is slow and on the order of months for me.

      Because my vision insurance sucks (which is to say that I don’t have any), I haven’t had any diagnostics since the first incident and I’ve never been treated. From my reading, available treatments MAY but do not necessarily increase the rate of resolution but do not affect the rate of recurrence. That simply isn’t a good value proposition to me.

      I do have permanent damage from — I think — the first incident. It’s a pinpoint blurred dot just off the middle of my vision. I can live with that. But if my vision was peppered with them, I would be truly bummed.

  5. Anonymous says

    Central Serous Retinopathy (CSR)

    CSR is mostly a stress condition. One stressful event or overall stress will cause it, Also high cortisone levels. The more you focus on it, the worse it will get. It may be associated with high cortisone and possibly Cushing syndrome, insomnia, stress and hypertension.

    My conclusion after 20 years of experience with CSR:

    My Action plan:
    1. Avoid Stress. Try stress reduction-meditation, etc.. Get enough sleep.
    2. Avoid excess salt (sodium), Crackers, sodas, pizza, etc. (salt has stimulating qualities and can worsen insomnia, hypertension, edema, etc.). It seems to make my CSR worse.
    3. Avoid all stimulants, caffeine, tobacco, herbal stimulants, albuterol, Etc
    4. Some Studies have shown taking vitamins and supplements may make CSR worse or have no effect. Avoid most of them. Just one study: http://www.omicsonline.org/exacerbating-factor-of-central-serous-chorioretinopathy-2155-9570.1000259.pdf. Most herbs and vitamins seem to make my eves worse.
    5. Avoid all forms of Cortisone.
    6. Exercise, walk, swim, get a hobby that does not require eye strain or videos.
    7. Avoid excess computer, cell phone, TV, Video usage.
    8. Do Bates eye exercises (Bates Method). See YouTube for instructions. Do sunning with eyes closed, palming and swings.
    9. Work Reflexology eye points around the toes, see chart below.
    10. Monitor your blood pressures and stress level.
    11. Work Eye acupressure points, see chart below and Google.
    12. Eat spinach and some form of blueberries 3 times a week to avoid macular degeneration.
    13. Find yourself a good Retina specialist.

    Work Reflexology eye and ear points or any sore points around the toes:

    Bates method, see YouTube for a demonstration:
    1. Long Swings 5 to 10 minutes 2 to 3x per day.
    2. Palming 5 to 10 minutes 2 to 3x per day.
    3. Sunning with eyes shut only.

    Most vitamin and supplements seem to make my eye worse, Q10, etc. Potassium (Potassium chloride) in small doses (99MG) or less is the only one that seemed to help me reduce the distortion/fluid buildup. It costs about $5 for a bottle of 100 tablets. Always take potassium with food to avoid an upset stomach. Warning Potassium chloride is extremely toxic in large doses. Check with your doctor before using. Other forms of potassium may or may not work. The Potassium seems to reduce my distortion and fluid buildup however it may or may not result in a seal of the leak or a complete resolution.

    Google “eye acupressure” for more details. Work acupressure points around eyes:

    The above instructions have shortened my CSR duration by weeks or months.

    The more you focus on CSR, the worse it will get and the longer it will take to resolve.

    I am not a doctor. I do not treat, diagnose or prescribe. If you have any illness, please refer to a medical doctor for advice. The above text is for information use only. I have no conflict of interest.


    • Raeph says

      @Anon Interesting comments about supplements and CSR. My CSR flared up today and I recently started taking Magnesium Chloride and B12 supplements. The Magnesium has been great for my skin and sleep and I ‘feel’ good, but my eye seems unhappy again.


    Hi. I have recurrent CSR bilaterally for 4 years now. It started to affect my right cental vision and I now have damage to my macula. Permanent distortion. It was not affecting the left central until recently and I am petrified. I have been seeing a great retina specialist. One who thinks outside the box , as any of you know there are not many treatments for this disease. I believe it was a result of a course of epidural steroid injections I received for back pain. In any case because I also have Nyclatopia dyschromatopia, metamorphisia , contrast sensitivity and choroidal neovascularization, my Dr and I decided to start treating with Eyelea with some success. At least we think. My right went from 20/200 to 20/25. I still have the issues mentioned and recurring fluid but it seems to be a sort of bandaid to help curtail the fluid and frequency. I have been looking for people to talk to about this disease. I am so afraid I will lose my sight. It could be 10 years. Could be 2. Who knows. My dr has never treated a case like mine and being the nerd, haha, that he is , finds it fascinating and is working to research more options for me. Thank goodness. I just wanted to share some of my experience. Feel free , anyone to reach out if you have questions about it. Thanks for listening. Nadine P., Raleigh NC.


    Todd I also have some ideas if assistive technology for the visually impaired if your interested in hearing about it.

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