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34-year-old man was seen in the office on 5/18/2012. He noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting. You saw a problem in the macula and suggested he come here for an evaluation. He is not taking any steroids, nasal inhaler, or any phosphodiesterase inhibitors. VISUAL ACUITY: Vision OD is 20/40, OS is 20/16. IOP: OD 16, OS 14. SLIT LAMP EXAM: Normal with clear lenses, except the left eye does have a nevus on the lid margin which he says has been there for a long time. It is on the lower lid about a millimeter in size. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. There is serous macular detachment. OS: Vertical C/D ratio is 0.0. There is no posterior vitreous separation. There is lattice degeneration inferiorly. OCT SCAN: The OCT scan of the right eye shows a serous retinal detachment. The average central foveal thickness is 588 microns. OCT SCAN: The OCT scan of the left eye is normal. PHOTOGRAPHS: The photo in the right eye shows a serous macular detachment centrally with some blunting of the retinal reflex. The left eye does show some dilated retinal veins; however, there is no evidence of any macular pathology. FLUORESCEIN ANGIOGRAPHY: The right eye does show a focal leaky spot just inferior to the fovea, about 500 microns, at the edge of the foveal avascular zone and there is leakage of fluorescein emanating off of the spot superiorly. The FA of the left eye is normal; however, the retinal veins are slightly dilated. IMPRESSION: 1. IDIOPATHIC CENTRAL SEROUS RETINOPATHY – RIGHT EYE DISCUSSION: I explained to the patient he does have central serous retinopathy in the right eye. About 95% of these cases will improve over the course of about a month or two, sometimes taking as long as six months. I asked him, here going forward, to avoid any sort of steroid preparations because that is a contraindication in patients with central serous retinopathy.

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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram - Antimated .GIF861 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram - Animated .GIF770 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma01.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 755 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma02.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 814 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma03.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 710 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma04.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 716 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma05.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 706 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma06.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 712 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma07.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 706 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma08.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 792 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma09.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 798 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma10.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 789 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma11.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 987 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma12.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 728 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma13.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 711 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma14.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 656 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma15.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 720 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma16.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 712 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma17.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 703 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma18.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram 699 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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csrsmokestack_blma19.jpg
Acute Central Serous Retinopathy - Classic Smokestack on Fluorescein Angiogram - OCT770 views34-year-old man noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/16
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34-year-old man was seen in the office on 5/18/2012. He noticed about five days ago decreased vision in the right eye. He was having difficulty playing video games and seeing with that eye. He thought maybe his refractive error was shifting. You saw a problem in the macula and suggested he come here for an evaluation. He is not taking any steroids, nasal inhaler, or any phosphodiesterase inhibitors. VISUAL ACUITY: Vision OD is 20/40, OS is 20/16. IOP: OD 16, OS 14. SLIT LAMP EXAM: Normal with clear lenses, except the left eye does have a nevus on the lid margin which he says has been there for a long time. It is on the lower lid about a millimeter in size. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. There is serous macular detachment. OS: Vertical C/D ratio is 0.0. There is no posterior vitreous separation. There is lattice degeneration inferiorly. OCT SCAN: The OCT scan of the right eye shows a serous retinal detachment. The average central foveal thickness is 588 microns. OCT SCAN: The OCT scan of the left eye is normal. PHOTOGRAPHS: The photo in the right eye shows a serous macular detachment centrally with some blunting of the retinal reflex. The left eye does show some dilated retinal veins; however, there is no evidence of any macular pathology. FLUORESCEIN ANGIOGRAPHY: The right eye does show a focal leaky spot just inferior to the fovea, about 500 microns, at the edge of the foveal avascular zone and there is leakage of fluorescein emanating off of the spot superiorly. The FA of the left eye is normal; however, the retinal veins are slightly dilated. IMPRESSION: 1. IDIOPATHIC CENTRAL SEROUS RETINOPATHY – RIGHT EYE DISCUSSION: I explained to the patient he does have central serous retinopathy in the right eye. About 95% of these cases will improve over the course of about a month or two, sometimes taking as long as six months. I asked him, here going forward, to avoid any sort of steroid preparations because that is a contraindication in patients with central serous retinopathy.