Recurrent Central Serous Retinopathy with Permanent Visual Loss in a U.S. Naval Fighter Pilot

Central serous retinopathy (CSR) is a disease process that involves accumulation of serous fluid within the macular retina. This fluid accumulation can temporarily or permanently disrupt vision and in many patients is often a recurrent problem. This case describes recurrent CSR in an experienced U.S. Naval F/A-18 fighter pilot. The patient had been troubled by recurrent CSR for several years which required him to be removed from a flying status. After several episodes and treatment with laser photocoagulation and finasteride, the patient's vision and disease process stabilized, but with permanent defective visual acuity in the right eye. There have been many case reports documenting CSR in active duty military aviators worldwide, including flying pilots who have residual permanent loss of visual acuity; however, this is the first U.S. Naval pilot who has been granted a waiver to return to unrestricted flight status with permanent defective visual acuity.