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A patient presented during a routine exam with a past history of “water in the back of the eye” many years ago. Their last exam two years ago showed improvement. Today, visual acuity is excellent with no reported distortion or Amsler abnormalities. The optometrist noted some retinal findings and advised the patient to avoid corticosteroids, manage stress, and consider lifestyle changes.
Is any further workup or treatment needed at this time?
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Care1 Retina Surgeon’s Clinical Insight
This patient has pachychoroid syndrome and old central serous retinopathy in the left eye. Fundus photography reveals pachydrusen, and OCT imaging shows a thickened choroid. In the left eye, there is a small pigment epithelial detachment (PED) without any associated subretinal fluid. A prominent choroidal vessel is noted beneath the PED, consistent with pachychoroid features. Steroid medications, including topical, nasal, or inhaled forms, should be avoided unless absolutely necessary. No other lifestyle modifications are recommended. Continued observation and follow-up are appropriate, and the Care1 ophthalmologist will remain available to assist with ongoing management.
Central serous chorioretinopathy (CSCR) is a retinal disorder characterized by serous detachment of the neurosensory retina due to hyperpermeability of the choroidal vasculature and dysfunction of the retinal pigment epithelium (RPE). It most commonly affects men aged 20 to 50 and presents with acute or subacute central vision changes such as distortion and decreased contrast sensitivity. While the exact cause is unknown, CSCR is strongly associated with corticosteroid use, stress, and increased sympathetic activity. Recurrence occurs in a significant portion of patients, and chronic cases may lead to lasting retinal changes.
Approximately 90% of acute CSC cases resolve spontaneously within 3 to 4 months without treatment.
Liew G, Quin G, Gillies M, Fraser-Bell S. Central serous chorioretinopathy: a review of epidemiology and pathophysiology. Clin Exp Ophthalmol. 2013;41(2):201–214. doi:10.1111/j.1442-9071.2012.02848.x
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https://start.care1.ca/patient-exam/118364
Preview Text: Patient with past retinal fluid has stable vision and no symptoms. Specialist review recommends monitoring and lifestyle advice.
A patient presented during a routine exam with a past history of “water in the back of the eye” many years ago. Their last exam two years ago showed improvement. Today, visual acuity is excellent with no reported distortion or Amsler abnormalities. The optometrist noted some retinal findings and advised the patient to avoid corticosteroids, manage stress, and consider lifestyle changes.
Is any further workup or treatment needed at this time?
Care1 helps you collaborate with specialists and AI
✔ Deliver the highest standards of care
✔ Increase patient satisfaction
✔ Retain your patients
✔ Stimulate revenue
The patient likely has a history of chronic central serous chorioretinopathy. Although vision remains excellent and there are no current symptoms, subclinical or chronic cases may still carry risk for long-term retinal changes. The recommended approach of avoiding corticosteroids and focusing on stress and lifestyle management is appropriate. No intervention is needed at this time. Continued monitoring is suggested, and the Care1 ophthalmologist will remain available to review future imaging and clinical updates.
This patient has pachychoroid syndrome and old central serous retinopathy in the left eye. Fundus photography reveals pachydrusen, and OCT imaging shows a thickened choroid. In the left eye, there is a small pigment epithelial detachment (PED) without any associated subretinal fluid. A prominent choroidal vessel is noted beneath the PED, consistent with pachychoroid features. Steroid medications, including topical, nasal, or inhaled forms, should be avoided unless absolutely necessary. No other lifestyle modifications are recommended. Continued observation and follow-up are appropriate, and the Care1 ophthalmologist will remain available to assist with ongoing management.
Actual Review: This patient has pachychoroid syndrome and old central serous retinopathy in the left eye. Fundus photos show pachydrusen. OCT shows a thickened choroid. In the left eye, there is a small PED but no subretinal fluid. Under the PED, there is a very large choroidal vessel. Avoid steroid medications (creams, nasal spray, puffers/inhalers) unless it is really necessary. No other restrictions or lifestyle changes. Continue with observation and follow-up with you as scheduled. I will continue to assist with management via review of the patient's file and diagnostic testing.
Central serous chorioretinopathy (CSCR) is a retinal disorder characterized by serous detachment of the neurosensory retina due to hyperpermeability of the choroidal vasculature and dysfunction of the retinal pigment epithelium (RPE). It most commonly affects men aged 20 to 50 and presents with acute or subacute central vision changes such as distortion and decreased contrast sensitivity. While the exact cause is unknown, CSCR is strongly associated with corticosteroid use, stress, and increased sympathetic activity. Recurrence occurs in a significant portion of patients, and chronic cases may lead to lasting retinal changes.
Approximately 90% of acute CSC cases resolve spontaneously within 3 to 4 months without treatment.
Liew G, Quin G, Gillies M, Fraser-Bell S. Central serous chorioretinopathy: a review of epidemiology and pathophysiology. Clin Exp Ophthalmol. 2013;41(2):201–214. doi:10.1111/j.1442-9071.2012.02848.x
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👁️ An optometrist uploaded this case to Care1.
A patient with a past history of “water in the back of the eye” presented during a routine exam. Vision is excellent, with no distortion or Amsler abnormalities. The optometrist noted retinal findings and advised avoiding corticosteroids, managing stress, and lifestyle adjustments.
📸 Fundus photos show pachydrusen. OCT shows a thickened choroid and a small pigment epithelial detachment (PED) in the left eye, but no subretinal fluid. A large choroidal vessel lies beneath the PED, consistent with pachychoroid features.
#optometry #ophthalmology #collaborativecare #retina #eyecare #CSCR #Care1 #telemedicine #medialAI #healthtech #digitalhealth #sharedcare #virtualhealth #optometrylife #ophthalmologylife
👨⚕️ Care1 Retina Surgeon’s Key Takeaways
The patient likely has pachychoroid syndrome with old central serous retinopathy. Excellent vision and no symptoms. Avoid steroid medications unless absolutely necessary. Continued observation and follow-up are appropriate. Care1 specialists remain available for future reviews.
👉 Read the full specialist consult: LINKTOBLOG
💡 Did You Know?
Approximately 90% of acute central serous chorioretinopathy (CSC) cases resolve spontaneously within 3–4 months without treatment.
📚 Liew G, Quin G, Gillies M, Fraser-Bell S. Clin Exp Ophthalmol. 2013.
Want faster input from a specialist without sending patients out of the clinic?
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An optometrist uploaded this case to Care1.
A patient with a past history of retinal fluid presented during a routine exam. Visual acuity is excellent, with no distortion or Amsler abnormalities. The optometrist identified pachydrusen on fundus photography, a thickened choroid, and a small pigment epithelial detachment (PED) in the left eye, with a prominent choroidal vessel beneath it. Corticosteroids were advised against, and stress and lifestyle management were recommended.
#optometry #ophthalmology #eyecare #retina #Care1 #collaborativecare
👨⚕️ Ophthalmologist’s Key Takeaways
The patient likely has pachychoroid syndrome with old central serous retinopathy. Excellent vision and no symptoms. Avoid steroid medications unless absolutely necessary. Continued observation and follow-up are appropriate. Care1 specialists remain available for future reviews.
💡 Did You Know?
Approximately 90% of acute central serous chorioretinopathy (CSC) cases resolve spontaneously within 3–4 months without treatment.
📚 Liew G, Quin G, Gillies M, Fraser-Bell S. Clin Exp Ophthalmol. 2013.
Want faster input from a specialist without sending patients out of the clinic?
👉 Learn more or book a demo: care1.ca/demo
An optometrist uploaded this case to Care1.
A patient with a history of retinal fluid presented during a routine exam. Their vision remains excellent, with no distortion or Amsler abnormalities. The optometrist noted subtle retinal findings and counseled the patient to avoid corticosteroids, manage stress, and consider lifestyle changes.
Fundus photos revealed pachydrusen. OCT showed a thickened choroid and a small pigment epithelial detachment (PED) without subretinal fluid. A large choroidal vessel was noted beneath the PED, consistent with pachychoroid features.
#optometry #ophthalmology #collaborativecare #retina #eyecare #Care1
👨⚕️ Ophthalmologist’s Key Takeaways
The patient likely has pachychoroid syndrome with old central serous retinopathy. Excellent vision and no symptoms. Avoid steroid medications unless absolutely necessary. Continued observation and follow-up are appropriate. Care1 specialists remain available for future reviews.
💡 Did You Know?
90% of acute CSC cases resolve spontaneously within 3–4 months without treatment.
📚 Liew G, Quin G, Gillies M, Fraser-Bell S. Clin Exp Ophthalmol. 2013.
Want faster input from a specialist without sending patients out of the clinic?
👉 Learn more or book a demo: care1.ca/demo
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