Central serous retinopathy (CSR)

Central serous retinopathy (CSR) is a common eye health issue that causes problems in your central vision. Your central vision is what you see straight ahead of you.

CSR affects six times more men than women and it usually starts in people ages 20 to 50. For most people, it will get better without treatment. For others, it may stay the same or get worse.

CSR is caused by a buildup of fluid underneath your macula. The macula is used to see details clearly. It’s used when you read, drive, or look at faces.

The fluid can cause your macula to lift up. Sometimes the macula will become completely separated from the eye tissue behind it. This makes vision blurry. It can also change how you see colour.

CSR is also known as:

Central serous chorioretinopathy
Central serous choroidopathy

This page will explain more about CSR, how it’s diagnosed, and what to expect if you need treatment.

On this page:

What causes CSR?
What are the symptoms?
How is it diagnosed?
Managing central serous retinopathy
How to reduce your risk
Living with central serous retinopathy
Current research into CSR
Support & resources
FAQs

What causes CSR and who is at risk?

Doctors don’t know what causes the fluid buildup seen in CSR. Research has shown that some things can make it more likely to occur:

Having too much stress in your life. Stress raises the levels of cortisol (stress hormone) in your body which can make CSR worse.
Corticosteroids – drugs which reduce swelling in the body - can also worsen symptoms.
Bacterial infections, such as H. pylori.
Cushing’s syndrome
Poor sleep quality – people who have sleep apnoea (when you stop breathing during sleep several times a night) are more likely to develop CSR.
Pregnancy – hormonal changes can increase the thickness of a layer of the eye called the choroid.
Family history – some studies have found that you’re more at risk from CSR if relatives have it

How to recognise early symptoms of central serous retinopathy

Not everyone with CSR will have symptoms. For some people, CSR can cause problems with their vision quickly. Their symptoms can also change from day to day.

People who have CSR usually notice:

Blurry vision
Straight lines start to look wavy or distorted
Patches in the centre of their vision that are dark grey
Colours look less bright
Problems seeing in low and bright light
Objects look smaller than they should
Things look further away than they are

If you notice any of these changes, arrange to see an eye specialist as soon as you can. You can also call our helpline for advice on 0330 3030 111.

How central serous retinopathy is diagnosed: tests and what to expect

If you experience changes in your vision, an eye specialist will run some tests. It can be difficult to tell CSR apart from other eye conditions.

The tests may include:

OCT tests: OCT stands for optical coherence tomography. This is a painless eye scan that takes a 3D picture of your retina. It can be done at an optician’s practice. The test will measure how thick your retina is. It can also see if your retina is swollen or if there is fluid in any of the retinal layers.
Fluorescein angiography: in this test, a dye is injected into your arm which then travels to your eye. This will help eye specialists see changes in your retina and in the blood vessels in the retina to try and detect where the fluid is coming from. The dye can stain your skin and will colour your urine temporarily. It will eventually go away by itself and has no lasting effects.
Indocyanine green angiography: like fluorescein angiography, this involves a dye which is injected into your arm. The eye specialist will also use a special light to see blood vessels in your retina.

Looking for information about living with a macular condition?

Call the Macular Society Helpline on 0300 3030 111 or email help@macularsociety.org

Managing central serous retinopathy: treatments, lifestyle changes, and support

Many people with CSR do not need any treatment. The symptoms will gradually go away over a few weeks or months. CSR can come back (recur) and last longer than before. This happens in about 50% of people who get CSR.

Most people experience symptoms for four to six months. If it doesn’t go away after this time, you may need treatment.

Your eye specialist will tell you if they recommend treatment or think you should just “wait and see” if it goes away. If you decide to wait, you will have repeat tests to make sure the fluid is going away.

If you’re taking medications that make CSR worse, your doctor may advise you to stop. Never stop taking medication without speaking to a doctor. You may need to reduce how much you take slowly over time (weaning). Stopping medicines suddenly can cause health problems.

If the symptoms do not go away and the fluid does not go away, you may need treatment. These treatments can include:

Medications to prevent blood vessels from leaking, usually given by injection. They’re called anti-VEGF injections, and they work by stopping the blood vessels from leaking.
Photodynamic therapy (PDT), which is a laser treatment to close the leaking blood vessels.
Micropulse or focal laser treatment which aims to help the retina reabsorb the fluid. You might feel worried about having injections, which is very normal.

Understanding what happens during injections can put your mind at rest.

How to reduce your risk of central serous retinopathy (CSR)

Though it’s not known why some people get CSR, there are things you can do to reduce your risk:

Take steps to reduce your stress levels. Stress makes your body produce more of a hormone called cortisol. Cortisol is known to make CSR worse.
Make sure you get regular exercise and enough sleep to help you manage stress.
Minimise the use of corticosteroids, if you can. These drugs, which are used to stop swelling (inflammation) in the body, can increase your risk of getting CSR.

Finding out you have CSR early is important to stop permanent changes to your sight. If you notice changes to your vision, seek help straight away.

Living with central serous retinopathy

Though CSR can eventually go away on its own, managing daily life while you’re experiencing symptoms can be difficult. There are a few things you can do to make life easier with CSR:

Try to get good sleep, ideally at least seven hours a night.
Reduce or limit the amount of caffeine and alcohol you consume. These drugs affect your sleep and stress levels.
Try to reduce the amount of stress you experience. This might mean changes to your relationships, work or daily activities.
Use low vision aids when CSR symptoms are bad. Magnifying glasses and screen readers can help you make text bigger.

Practical tips for daily life with CSR

It’s important not to strain the retina with bright light, especially if you have had treatment.

Wearing sunglasses that have 100% ultraviolet (UV) protection is important on sunny days.

Reduce eye strain by changing the lighting in your home. If you need help with this, you can find more advice in our helpful lighting guide.

Current research and developments for central serous retinopathy

Scientists are learning more about CSR all the time. Research aims to find out what the causes are and how to treat them.

Studies show that photodynamic therapy (PDT) works well. It helps make vision better and stops fluid building up.

Scientists have also been looking at using smaller doses of PDT. They have found this is safer and works better for people with CSR.

Doctors are also looking at:

New types of laser treatment
Medicines like spironolactone (medicines that change hormone levels). More research is needed to work out how to use these drugs.
How stress hormones affect CSR
New scanning methods like OCT angiography (OCTA) which can see the damage to the eye better than other tests.

Support & resources

Dealing with CSR on a daily basis can be very hard, and many people find it makes them anxious. You might find that you’re worried that it won’t get better, or you’re frightened about treatment. Whatever is most concerning for you, talking about it can help. For most people, CSR will get better over time.

The Macular Society provides a range of support services. We have a helpline you can call on 0300 3030 111 to ask all your questions. We also have counselling services, befriending and details of local support groups.

FAQs

Will CSR go away by itself?

For most people, yes, it will go away within about 4-6 months. For others, this might not happen, and they may need treatment.

Can CSR come back (recur)?

Yes, for about half of the people who have had CSR once, it will come back. It might last longer than the time before.

If I am taking steroids, should I stop taking them?

Do not stop taking any medicines, including steroids, without talking to your doctor. You might have to stop taking them, but it depends on your doctor’s advice. You might have to slowly reduce how much medicine you take over time. This is called weaning.

When should I get help with CSR?

If you notice changes in your vision, get help straight away. You might notice a dark patch or blurry vision. It might be harder to see in bright or dark light levels. If you have any changes in your vision, make an appointment with an eye specialist.

Last review date: 08/2026

Next review date: 08/2028

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