Fluid Behind the Retina: Causes, Diagnosis and Treatment (2023)

The retina at the back of the eye is the tissue you rely on for sight. The eyes themselves are fed by numerous blood vessels and filled with fluid. Sometimes, though, there can be problems. Fluid can build up behind the retina due to different conditions, including macular edema and central serous retinopathy.

Here's what to know to recognize what may be causing fluid underneath the retina and the steps you need to take for appropriate diagnosis and treatment.

Fluid Behind the Retina: Causes, Diagnosis and Treatment (1)

Causes of Fluid Behind the Retina

More than one thing can cause fluid to build up behind the retina. So it's important to take a closer look to determine the reason in your case.

Macular Edema

With macular edema, fluid builds up in an area of the retina known as the macula. This is the area that you rely on for sharp central vision. If fluid builds up underneath, it can get distorted as the tissue swells.

Fluid leakage can come from damaged blood vessels nearby in the retina. This can be the result of a number of different conditions. Macular edema can be caused by any disease that damages blood vessels and can even result from eye surgery.

Central Serous Retinopathy

With central serous retinopathy, fluid can build up under the retina. The retinal pigment epithelium (RPE), which is between the choroid and the retina, stops functioning as it should. Without this working right, fluid begins to build up under the retina.

This can cause visual distortion and even a slight retinal detachment in some cases. Those most at risk for this condition are men ranging in age from their 30s to their 50s, people with type A personalities, those taking steroids, and people with autoimmune disorders.

Diabetic Retinopathy

Cases of diabetic retinopathy result from the elevated blood sugar that occurs in those who have diabetes. Over time, high amounts of sugar in the blood can damage the retina by affecting the blood vessels. The blood vessels swell, and the tight junctions in them break down, leading to bleeding or leaking fluid.

Also, glycosylated red blood cells (which have sugar bound to the hemoglobin) do not bring enough oxygenated blood. This triggers the formation of new blood vessels. These, however, are fragile and easily leak and bleed further. This leads to more fluid behind the retina and ultimately may end up in a detachment.

Choroidal Effusion

The choroid is a layer of spongy blood vessels between the retina and the white part of your eyes, known as the sclera. The role of the choroid is to deliver nutrition and oxygen to the outside portion of the retina.

If fluid or blood (choroidal effusion) gets between the choroid and sclera, it can lead to a detachment, known as serous choroidal detachments. These are generally related to low intraocular pressure, usually following recent glaucoma surgery.

This decrease in pressure allows the fluid to accumulate in the space around the cells while the capillaries become more permeable due to inflammation.

Diagnosis of Fluid Behind the Retina

To determine if you may have fluid beneath the retina, your eye doctor will thoroughly examine your eyes. Some of the tests they will likely use may include:

Amsler Grid Test

An Amsler grid test is an easy way to determine if your all-important central vision has changed. With this test, you simply look at the grid-like squares and tell the doctor whether any of the lines look wavy or if there are any missing areas. This can help to detect even minor vision changes.

Optical Coherence Tomography (OCT)

Optical coherence tomography takes cross-sectional pictures of your retina with a special camera. It can measure retinal thickness and detect fluid beneath the retina and swelling. With this information, your doctor can determine whether you need treatment for any fluid trapped under the retina.

Fundus Autofluorescence (FAF)

With autofluorescence imaging, the idea is to make use of the retina's naturally occurring fluorescence. Even without injecting any dye, when a blue light is used to illuminate the retina, certain structures glow.

These glowing structures can be captured in a black and white image. Characteristic patterns may then indicate that diseases like age-related macular degeneration or central serious retinopathy are progressing and can help indicate appropriate treatment.

(Video) Ophthalmologist & Retina Specialist Dr. Urvashi Goja explains about Retinal Diseases & Complications

Fluorescein Angiography

Fluorescein angiography can be used to diagnose swelling in the retina. With this, a yellow fluorescein dye is injected into your arm. When it reaches your eyes a few seconds later, it will cause them to shine brightly. A special camera can then be used to take pictures of the area. These can alert your doctor about what type of treatment is needed and where.

Indocyanine Green Angiography

With indocyanine green angiography, the dye works similarly to fluorescein but only can be viewed in infrared light. Also, it circulates deeper into the retinal layers where they can be photographed with an infrared-sensitive camera. This is often used for choroidal angiography to complement fluorescein angiography of the retina.

Ocular Ultrasound

With this test, also known as a b-scan ultrasound, sound waves are used to create a picture of structures within the eye. This technique can be used to detect complications such as retinal detachment, diabetic retinopathy, and eye cancers.

Treatment of Fluid Behind the Retina

Deciding on the best treatment for any particular case of fluid behind the retina will be based on the cause here. Some possible treatment approaches include the following:

  • Medications such as corticosteroids or anti-inflammatory drugs aim to quell inflammation. These can come in the form of drops, pills, or even dispersed via extended-release devices in some cases.
  • Sometimes, it may be necessary to use a surgical approach such as a vitrectomy in which the jelly-like substance that normally fills the eye is removed.
  • In some cases, such as in diabetic retinopathy, laser treatment may stop blood vessels from leaking and reduce retinal swelling.
  • If you have macular edema, you may be treated with what's known as anti-VEGF injections. Vascular endothelial growth factor (VEGF) is a protein that leads to the production of new blood vessels. With macular edema, these blood vessels may leak. The use of anti-VEGF can slow the production of these new blood vessels.
  • Making lifestyle changes, such as controlling blood sugar levels in the case of diabetic retinopathy, should also be kept in mind when considering how to help alleviate fluid behind the retina.

Summary

Fluid beneath the retina can occur due to inflammation or leaking blood vessels in conditions such as diabetic retinopathy, macular edema, central serous retinopathy, and choroidal effusion. An eye doctor will perform an eye exam and may use various imaging methods to assess the problem.

Treatment depends on the condition causing the fluid buildup. Anti-inflammatory medications, surgery, laser treatment, anti-VEGF injections, or lifestyle changes may be used.

A Word From Verywell

Fluid beneath the retina can come from a variety of sources. The good news is once practitioners figure out what may be at the root in your particular case, there are many different treatments that may alleviate this and help to preserve your vision.

Frequently Asked Questions

  • How do you get rid of fluid behind the retina?

    This depends on the cause. Once this is diagnosed, you may simply be given medication to tamp-down inflammation, or may need to undergo laser treatment to seal blood vessels, or may need some treatment with anti-VEGF injections, among other possibilities.

  • Can fluid behind the eye cause blindness?

    It is possible. Fluid behind the retina can sometimes lead to a retinal detachment, pushing the retina away as it collects. This is known as an exudative retinal detachment. If the detachment is not promptly treated and is extensive enough, this can cause permanent vision loss.

    Learn More:What Is a Detached Retina?

    (Video) Retinal Detachment | Types, Risk Factors, Pathophysiology, Signs & Symptoms, Diagnosis, Treatment
  • Is fluid behind the eye serious?

    While it may not cause vision loss in all cases, fluid behind the eye is not normal. Therefore, it is important to promptly see a doctor and find out what is causing this so it can be treated.

    Learn More:What Is Excess Fluid in Eyes?

  • Yes, eating fiber-rich fruits like bananas, apples, and berries, which are metabolized more slowly and lead to fewer blood sugar fluctuations, are helpful for macular degeneration. Also suitable are high-fiber vegetables like broccoli, corn, carrots, leafy greens, legumes and beans, and whole grains.

    Learn More:How to Prevent Macular Degeneration

12 Sources

(Video) Retinal Detachment Symptoms and Treatment | How Retinal Detachment is Treated

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. American Academy of Ophthalmology.What causes macular edema?

  2. American Academy of Ophthalmology. Central serous retinopathy.

  3. American Diabetes Association.Eye complications.

  4. Schrieber, C, Liu, Y.Choroidal effusions after glaucoma surgery.Curr Opin Ophthalmol.2015; 26(2):134–142. doi:10.1097/ICU.0000000000000131

  5. American Academy of Ophthalmology. What is optical coherence tomography.

  6. The University of British Colombia. Autofluorescence imaging.

  7. American Academy of Ophthalmology. What is fluoroscein angiography.

  8. University of Iowa. Indocyanine green angiography.

  9. Retina Macula Institute. Ocular ultrasound.

  10. National Eye Institute. Macular edema.

  11. National Eye Institute. Diabetic retinopathy.

  12. American Academy of Ophthalmology. Anti-VEGF treatments.

Fluid Behind the Retina: Causes, Diagnosis and Treatment (2)

(Video) Macular Degeneration - vision disease - 3D animation

By Maxine Lipner
Maxine Lipner is a long-time health and medical writer with over 30 years of experience covering ophthalmology, oncology, and general health and wellness.

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(Video) What is Central Serous Retinopathy | Symptoms, Prevention, Treatment and More

FAQs

What causes fluid under the retina? ›

In the retina, blisters of fluid form and swell the retina—this is macular edema. Factors likely to cause macular edema include conditions that: Cause more fluid to leak from blood vessels (diabetes and high blood pressure) Increase inflammation in the eye (surgery, inflammatory diseases)

What causes fluid on the eye? ›

There are several types of excess fluid in the eye, depending on the health issue that is causing fluid to build up. Conditions that are known to cause excess eye fluid include, macular edema, diabetic macular edema, central serous retinopathy, macular degeneration, and glaucoma, among others.

Can stress cause fluid behind eyes? ›

Stress causes the body to produce a hormone called cortisol. Cortisol can cause inflammation and leaks. This leakage may lead to fluid building up in the back of the eye.

How serious is fluid behind the eye? ›

Excess fluid inside the eye can lead to sight-threatening eye diseases— making early diagnosis absolutely vital. Collagen, water and protein are the primary materials that make up the eye — but sometimes, a surplus of fluid can accumulate inside the eye, increasing the risk of serious eye diseases.

What are the 2 types of fluid in the eye? ›

Vitreous and Aqueous Humor

Gel-like fluids inside the eye help it maintain its shape, which plays an important role in overall eye health. These substances are called the vitreous humor and aqueous humor.

Can fluid behind the eye cause headaches? ›

Papilledema is a serious medical condition in which the optic nerve at the back of the eye becomes swollen. The symptoms can include visual disturbances, headaches, and nausea.

What is fluid behind the eye called? ›

What is macular edema? Macular edema is swelling in part of the retina (the light-sensitive layer of tissue at the back of your eye). People with macular edema may have blurry vision, but treatment can help reduce the swelling and prevent vision loss.

What causes inflammation behind the retina? ›

Infectious retinitis is an inflammation of the retina resulting from infection by viruses, bacteria, fungi, or parasites. These pathogens affect patients differently depending on characteristics like age, location, and immune status. Treatment is aimed at preventing permanent vision loss and protecting the fellow eye.

What is fluid in the eye called? ›

The front part of the eye is filled with a clear fluid (called aqueous humor) made by the ciliary body.

Which vitamin causes macular edema? ›

The high dose of niacin led to cystoid macular edema of the retina, which is fluid in the macula (a small area in the center of the retina that produces detailed and centralized vision) that causes swelling.

Can retinal edema be cured? ›

The condition cannot be cured, although it can be treated. Retinal capillaries may be leaky for a number of different reasons depending on the underlying disease or type of condition.

What medications can cause macular edema? ›

Various agents can cause cystoid macular edema including topical epinephrine, nicotinic acid, topical prostaglandin analogs (e.g., latanoprost), antimicrotubule agents (paclitaxel, docetaxel), fingolimod, imatinib, glitazones (rosiglitazone, pioglitazone), and trastuzumab.

How long is the recovery from a vitrectomy? ›

After the surgery, your eye may be swollen, red, or tender for several weeks. You might have some pain in your eye and your vision may be blurry for a few days after the surgery. You will need 2 to 4 weeks to recover before you can do your normal activities again.

Can macular edema lead to blindness? ›

In severe cases, macular edema can result in blindness. Given the range of underlying conditions that may cause macular edema, the severity of vision loss and necessary treatment will vary from patient to patient.

Can you go blind from central serous retinopathy? ›

Central serous retinopathy, sometimes known as central serous choroidopathy (CSC), is a degenerative eye condition in which fluid builds up under the retina, leading to potential vision problems and blindness.

Can you go blind from central serous retinopathy? ›

Central serous retinopathy, sometimes known as central serous choroidopathy (CSC), is a degenerative eye condition in which fluid builds up under the retina, leading to potential vision problems and blindness.

How long does it take for central serous retinopathy to heal? ›

Most people will recover within four to six months without any need for treatment. CSR which lasts over 12 months. This is very rare but can lead to further changes such as RPE detachment or bullous retinal detachment.

How do you improve eye fluid? ›

Tips to Keep Your Eyes Hydrated
  1. Use artificial tears throughout the day if you are prone to dry eyes. ...
  2. Remember to blink when you use your computer, read, or play video games. ...
  3. Use a humidifier in your home during the fall and winter to keep the air moist.
  4. Stay away from cigarette smoke, which tends to dry out your eyes.

Which vitamin causes macular edema? ›

The high dose of niacin led to cystoid macular edema of the retina, which is fluid in the macula (a small area in the center of the retina that produces detailed and centralized vision) that causes swelling.

Can fluid behind the eye cause headaches? ›

Papilledema is a serious medical condition in which the optic nerve at the back of the eye becomes swollen. The symptoms can include visual disturbances, headaches, and nausea.

What is fluid in the eye called? ›

The front part of the eye is filled with a clear fluid (called aqueous humor) made by the ciliary body.

What is the best treatment for central serous retinopathy? ›

Several therapies have been used to treat chronic CSC, including thermal laser treatments, oral medications, and eye injections. A “cold laser,” called photodynamic therapy, is also effective and often used to focally treat the source of fluid leakage under the retina in chronic CSC.

Can glasses help central serous retinopathy? ›

Some people with central serous retinopathy will notice if they wear reading glasses, they can see better because the reading glasses can sometimes refocus the image on the elevated retina.

Can high blood pressure cause central serous retinopathy? ›

Hypertension has previously been reported as a possible risk factor for the development of central serous chorioretinopathy (CSCR).

How many people get central serous retinopathy? ›

Central serous chorioretinopathy is characterized by neurosensory detachment of the central retina secondary to fluid leakage through the retinal pigment epithelium. Though it has an incidence of 9,9 per 100.000 in men and 1,7 per 100.000 in women, it is the fourth most common retinal disorder.

What does vision look like with central serous retinopathy? ›

If you have central serous retinopathy, your central vision will be distorted. In addition to distorted central vision, your vision may also appear blurred or dim. You may have a blind spot in your central vision.

Does alcohol make central serous retinopathy worse? ›

Alcohol is a known risk factor for central serous chorioretinopathy (CSCR). It may contribute to nitric oxide-related abnormalities of autoregulation of the choroidal blood vessels.

Which vitamin is best for eyes? ›

Vitamin A is especially important for eye health. The American Academy of Ophthalmology explains that vitamin A helps your eyes produce pigments that make it possible to see the full spectrum of light. Vitamin A also nourishes other parts of your eye.

Which fruit is best for eye vision? ›

Look to Fruits and Vegetables for Good Eye Health
Foods Rich in Antioxidants for Eye HealthAntioxidants Related to Eye Health
Red berries, kiwi, red and green bell peppers, tomatoes, broccoli, spinach, and juices made from guava, grapefruit, and orange.Vitamin C (ascorbic acid)
5 more rows

How do you increase blood flow to the retina? ›

Carbon dioxide-oxygen.

You breathe in a mixture of carbon dioxide and oxygen to increase blood flow to the retina. It also widens the arteries.

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