When stress meets keratoconus: Bilateral central serous chorioretinopathy

Central serous chorioretinopathy (CSC) is a retinal condition in which fluid collects beneath the retina, lifting the light-sensing layer and blurring central vision. Most patients present with a single affected eye; they are often young men; and bilateral involvement is less common. When both eyes are affected, it is frequently in the setting of a trigger, with psychological stress among the most recognized. A young patient developed bilateral CSC shortly after experiencing acute psychological distress on learning of a new diagnosis of bilateral keratoconus. Clinical examination and multimodal imaging confirmed CSC in both eyes. We adopted a conservative, patient-centered plan, prioritizing lifestyle adjustments (rest, reduced stimulants) and structured psychological support. Under this approach, subretinal fluid resolved gradually and visual acuity improved markedly in both eyes. This case suggests that psychological stress can plausibly precipitate bilateral CSC and affirms the value of a comprehensive, patient-centered approach. For patients newly grappling with a chronic ocular diagnosis such as keratoconus, integrating ophthalmic care with structured psychosocial support may help optimize visual outcomes and enhance overall well-being.