Central Serous Retinopathy (CSR)

Central serous retinopathy is a small, round, shallow swelling that develops on the retina, the light sensitive nerve layer that lines the back of the eye. Although the swelling reduces or distorts vision, the effects are usually temporary. Vision generally recovers on its own within a few months.

In the initial stages of CSR, vision may suddenly become blurred and dim. If the macula-the area of the retina responsible for acute central vision-is not affected, there may be no obvious symptoms.

CSR typically affects adults between the ages of 20 to 50. People with CSR often lose their retinal swelling without treatment, and recover their original vision within six months of the onset of symptoms. Some people with frequent episodes may have some permanent vision loss. Recurrences are common and can affect 20 to 50 percent of people with CSR. While the cause of CSR is unknown, it seems to occur at times of major personal or work related stress.

As CSR usually resolves on its own, no treatment may be necessary. Sometimes laser surgery can reduce the swelling sooner but there is no evidence this improves the final visual outcome. If retinal swelling persists for over three to four months or if an examination reveals early retinal degeneration, laser surgery may be helpful.

Coats’ Disease

Coats’ disease is a chronic, progressive disorder that affects the retina, the light-sensitive nerve layer at the back of the eye. Coats’ disease is an abnormal growth spurt of the small blood vessels (capillaries) that nourish the retina. The fragile abnormal vessels break and leak the clear serum part of the blood into the retina, causing the retina to swell.

Coats’ disease usually affects children (especially boys) in the first ten years of life, but it can also affect young adults. The condition affects central vision, typically in only one eye. Severity can range from mild vision loss to total retinal detachment and blindness. No cause has yet been identified for Coats’ disease.

The leaking blood vessels can be treated with laser surgery or cryotherapy (freezing). If the retina is detached, a vitrectomy to replace the vitreous (the clear gel-like substance inside the eye) with a gas bubble may be necessary to restore vision.

Cotton-Wool Spots

Cotton-wool spots are tiny white areas on the retina, the layer of light-sensing cells lining the back of the eye. Caused by a lack of blood flow to the small retinal blood vessels, they usually disappear without treatment and do not threaten vision. They can, however, be an indication of a serious medical condition.

Diabetes is the most common cause of cotton-wool spots. The presence of more than eight cotton-wool spots has been associated with a higher risk of the more severe form of diabetic retinopathy known as proliferative diabetic retinopathy.

Cotton-wool spots are also a common sign of infection with the Human Immunodeficiency Virus (HIV). They are present in more than half of the people with full-blown AIDS. Their presence can be an important sign of the severity of HIV-related disease.