Central Serous Retinopathy

Central serous retinopathy (CSR), also known as central serous choroidopathy (CSC), is an eye condition that develops due to an accumulation of fluid under the retina. The fluid leaks from the choroid, the blood vessel layer under the retina, into the area beneath the retina. While central serous retinopathy usually affects one eye at a time both eyes can be affected at the same time. More men, in their mid 30's to 50's, are affected with central serous retinopathy than women.

Causes of CSR

The cause of central serous retinopathy is unknown. It is believed that patients who develop CSR have been exposed to treatments or experience certain medical conditions might trigger CSR. Possible triggers may include:

  • High stress/lifestyle
  • Steroid medication
  • Pregnancy
  • Excessive caffeine use
  • "Type A" personality traits
  • Nasal allergies
  • Asthma
  • High blood pressure

Symptoms of CSR

Patients with CSR may experience the following symptoms:

  • Blurred or dimmed vision
  • Blind spots
  • Distorted shapes
  • Decreased visual sharpness
  • Loss of depth perception

This can greatly interfere with reading, driving and other normal activities, and may affect a patient's quality of life throughout the duration of the condition.

Treatment of CSR

In most cases, treatment for CSR is not required; the condition improves on its own over a period of one to two months without treatment. Patients will need to be monitored for complications and to ensure that leaked fluid has been reabsorbed. For patients with complications, laser treatments may be required to seal the leakage to prevent permanent vision loss. More than half of the patients who develop central serous retinopathy have a recurrence of the condition.

Cystoid Macular Edema

Cystoid macular edema, also known as CME, is a swelling of the macula with fluid. The macula is responsible for the detailed, central vision that provides the ability to see objects with great detail. Swelling occurs as fluid builds up in the layers of the macula, gradually blurring vision.

Causes of Cystoid Macular Edema

Most cases of cystoid macular edema develop when blood vessels in the retina begin leak fluid. Patients who have cystoid macular edema may have the following contributing factors towards the condition:

  • Recent eye surgery, such as cataract surgery
  • Diabetes
  • Uveitis
  • Age-related macular degeneration
  • Medication
  • Family history
  • Glaucoma
  • Trauma
  • Retinal vascular disease

As swelling occurs, vision is affected. Peripheral vision, the side vision, remains unaffected.

Symptoms of Cystoid Macular Edema

While this condition does not usually cause pain for most patients, it can cause some of the following:

  • Increasingly blurry vision, especially when reading
  • Decreased central vision
  • Vision that is wavy
  • Decreased perception of colors
  • Retinal swelling or inflammation

For patients who have had cataract surgery, cystoid macular edema usually occurs about two to eight weeks after surgery. Vision may also be distorted, with straight lines appearing wavy, and may be tinted pink as well. Peripheral vision is usually not affected by this condition.

Diagnosis of Cystoid Macular Edema

After symptoms of cystoid macular edema are present, your doctor may perform a series of diagnostic tests to confirm diagnosis. They may include:

  • Fluorescein angiogram
  • Optical coherence tomography
  • Dilated eye examination

While this disease can be detected by your doctor before symptoms are present, it is usually very difficult to detect.

Treatment for Cystoid Macular Edema

Treatment for cystoid macular edema will vary depending on the severity and cause of the condition and the individual patient. Treatment may involve:

  • Ocular eye drops
  • Ocular injections
  • Anti-inflammatory medication
  • Diuretics
  • Vitrectomy surgery

Most patients experience significant improvements to their vision after one or more of these treatment options, with full recovery taking several months.

Flashes and Floaters

Flashes and floaters of the eye commonly occur as the result of age-related changes to the vitreous gel. At birth, the vitreous is firmly attached to the retina and is a thick, firm substance without much movement. As we age, the vitreous becomes thinner and more watery, and tissue debris that was once secure in the firm vitreous gel is now able to move around on the inside the eye, casting shadows on the retina.

Flashes that occur in vision are as a result of pressure on the retina, the bundle of nerves in the back of the eye where images are detected and transmitted to the brain, causing patients to see either flashing lights or lightning streaks.

Floaters occur when fibers move across the vitreous and into the field of vision, causing patients to see specks, strands, webs or other shapes as the fibers cast shadows on the retina.

These symptoms are most visible when looking at a plain, light background. Flashes and floaters often appear at the same time, although some patients may only experience one symptom.

While flashes and floaters are common, especially as we age, it is important to see your doctor if you experience them, as they may indicate a retinal tear or hole. Your doctor can distinguish between harmless flashes and floaters, and those that may require treatment for an underlying condition.

The sudden appearance of flashes, floaters and other visual disturbances may indicate the vitreous pulling away from the retina, leadind to a retinal detachment. Anyone experiencing these symptoms should seek immediate medical attention to reduce the risk of complications such as loss of vision.

Most flashes and floaters will become less noticeable with time as patients adjust their vision. While these floaters are harmless, it is important to continue to receive regular eye exams to ensure that any permanent changes to your vision do not occur.

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