Central serous retinopathy (CSR)
This is where fluid develops under the retinal layers at the macula. The typical history is of a blurred patch in the central vision in one eye. This may cause distortion (straight lines appear wavy/distorted/curved) and affects both near and distance vision. Peripheral vision is retained. It is typically unilateral and affects young males 20-40. There is some evidence it can be associated with steroid use and to anxiety and high stress. However, despite these associations with type A personalities there is no evidence that reducing stress levels will prevent its recurrence. It resolves spontaneously over a few weeks to months. Many only have one episode however a small number go on to develop a chronic retinopathy with recurrent episodes which can also be bilateral.
Who to refer:
Please see Lothian GP and optometry ophthalmology referral pathway.
Urgency of the condition for details on how soon patients should receive an appointment.
Please see condition specific information for descriptions and management of many common ophthalmological conditions.
Patients who present with a problem with their only seeing eye should be advised to see an optician/ophthalmologist for review.
Who not to refer:
Amaurosis fugax – please refer to the neurovascular clinic. Please assess vascular risk factors including blood pressure, cholesterol and diabetes.
How to refer:
We require a referral letter for EVERY patient.
The preferred referral process is via SCI Gateway. If sending/forwarding a referral via SCI gateway please include past medical history, allergies and medications
If you do not have access to fax or SCI Gateway e.g. if you have arranged an appointment out of hours please send a written referral letter with the patient to bring to their appointment.
Only if SCI Gateway is unavailable should a letter be typed or handwritten. Please write legibly and include your examination findings.
If you have arranged an appointment in the acute referral clinic and you are referring from within another hospital in Lothian please use TRAK to type the referral letter.
