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Provider photo for Eun-Ha Park

Eun-Ha Park, MD

Ophthalmology

Welcome to My Doctor Online, a website my colleagues and I developed to make it easier for you to take care of your healthcare needs. On this site you will find answers to many of your questions about my clinical practice. Also included are several online features that will allow you to e-mail me, check your laboratory results and refill prescriptions. If you are a patient who sees me regularly, you can reach my office directly at 650-301-5807

My Offices

Daly City Medical Offices
Appt/Advice: 650-301-5800

See all office information »

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Overview

Central serous retinopathy (CSR) is caused by a buildup of fluid underneath the retina. The retina is a thin layer of tissue that lines the back wall of your eye. It converts light into electrical signals and sends them to the brain to be converted into images.

The fluid leaks from a layer of blood vessels called the choroid. The choroid is separated from the retina by a layer of tissue called the retinal pigment epithelium (RPE). When the RPE doesn’t work properly, a pocket of fluid can develop under the retina, causing swelling. This can reduce and distort your vision. You may notice blind spots in your central vision if the swelling is located in the fovea. This is the pin-sized area at the center of the retina that ensures you can focus clearly when looking straight ahead.

Sometimes, the swelling resolves on its own, and your vision can return to normal after several months. However, some people continue to experience distorted vision and/or reduced color perception in the affected eye even after the swelling has gone away. 

Sometimes, CSR goes away but then comes back. If this happens frequently, CSR may become a chronic condition, although this is unusual. Chronic CSR may sometimes result in some permanent reduction in vision.

Symptoms

You may not have any symptoms if the fluid leak is small and not located in or near the macula. The fluid may be reabsorbed by the body without you noticing any symptoms in your eye. However, if the areas of swelling are larger and/or located on the macula, you may notice the following symptoms:

  • The center of your vision may have a blurred or blind spot.
  • Straight lines may appear distorted or wavy. 
  • Objects may appear smaller or farther away.

Causes and Risk Factors

Studies suggest that CSR is associated with certain age groups and lifestyle factors.  These factors may increase your risk for developing CSR:

  • Age. CSR typically affects adults between the ages of 20 and 50.
  • Gender. Significantly more men than women develop CSR.
  • Stress. CSR seems to be associated with stress. Studies suggest that if you work in a stressful occupation or consider yourself to be an “A” type personality, you may be at higher risk of developing CSR.
  • Steroid use. Long-term use of corticosteroids (pills by mouth, inhalers, topical creams, nasal sprays and other topical corticosteroid medications) can increase the likelihood that you will develop CSR.
  • Stimulants. Studies indicate that consuming excessive quantities of stimulants, such as coffee, tea, and alcohol, may increase your risk of developing CSR.

Diagnosis

We can schedule a general eye exam for you in either our Optometry or Ophthalmology departments. However, if you have sudden vision changes, contact us to schedule an urgent appointment with me or one of my colleagues in the Ophthalmology department.

We will ask you about your symptoms and examine your eyes. If we suspect that you have CSR, the examination will include the following tests:

  • Ophthalmoscopy. We use a strong light and magnifying lens to examine your retina and macula for signs of swelling and damage. We will administer eye-drops first to dilate your pupils so that we can see the structures at the back of your eye clearly.
  • Visual acuity test. Just like a regular eye exam, this tests the strength of your central vision by requiring you to read letters on a wall chart some distance away.
  • Fluorescein angiogram and optical coherence tomography (OCT). You may have a fluorescein angiogram and/or an OCT.   A fluorescein angiogram allows us to look closely at the blood vessels in your eyes and detect where the fluid is leaking from. We inject dye into a vein in your arm. As the dye travels through the blood vessels in your retina, photos are taken of your eye. An OCT test measures the thickness of your retina and looks for areas of swelling.  This can help us diagnose CSR. OCT is a type of scanner that uses light waves to map the retina and highlight any damaged areas. The test is noninvasive and painless.

Treatment

CSR usually has a good outcome, and it often gets better on its own without treatment. However, if your CSR has become chronic, we may discuss the risks and benefits of laser treatment with you.

Laser treatment

During laser photocoagulation, we use a laser to reduce the fluid leakage from the abnormal retinal pigment epithelium. These treatments may take about 10 to 20 minutes and are performed in our office. 

Sometimes laser treatment can reduce swelling more quickly than waiting for it to resolve on its own. However, the procedure does have risks. We usually recommend this approach only if the fluid under the retina and/or macula does not improve on its own.

LIfestyle Changes and Management

There are a number of steps you can take to reduce your risk of developing CSR or minimize its frequency. Talk to us about how we can help you make the following lifestyle changes:

  • Decrease stimulants. Reduce the amount of coffee, tea, and alcohol that you consume.
  • Manage stress. It is important to recognize the signs of stress and learn some techniques for stress management. Although stress is common, it can be significant. If untreated over time, stress can lead to high blood pressure (hypertension), heart disease, and stroke. Talk to your personal physician about relaxation techniques and other tools we offer that can help you manage stress.
  • Get lots of sleep. It is important to get sufficient sleep in order to manage stress and feel more relaxed. If you have trouble sleeping, we can recommend a number of programs and classes that can help you sleep well. 
  • Minimize steroid use. Steroids increase your risk of developing future episodes of CSR. If you take steroids for another condition, talk to your personal physician about the risks and benefits of discontinuing steroids.  
Additional References:

Your Care with Me

If your optometrist identifies signs of CSR during your eye exam, he or she will make an appointment for you to see me or one of my colleagues in the Ophthalmology department. If you are not scheduled for a regular eye exam and you notice symptoms such as blurry central vision or a blind spot, please call our Appointment and Advice line, which is available 24 hours a day, 7 days a week. Our advice nurses can give you immediate advice, and our telephone staff can send me a message or book an appointment for you.

Your first appointment is likely to take at least 1 hour and possibly longer. During your office visit, we will discuss your medical and family history and I will perform a comprehensive eye exam and some diagnostic tests.

I may administer eyedrops to dilate your pupils so that I can clearly see the structures of your eyes. Your pupils will remain dilated for several hours, so you may wish to bring someone who can drive you home after your exam.

I will explain the findings of your exam and answer any questions or concerns you may have. If you notice any new changes, please let me know.

If we decide that you need further evaluation, or further treatment or surgery, I will discuss the treatment options that are available, and together we will create a treatment plan that is right for you.

If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.

If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.

If you are experiencing an emergency, call 911 or go to the nearest Emergency Room.

Coordinating Your Care

Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.

Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.

When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

If you come to an office visit
  • At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization. We can discuss and schedule any preventive tests that you need. 
  • At the end of your visit, you may receive a document called the "After Visit Summary" that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed. You can also view it online under Past Visits.
  • To help you prepare for your visit, please see additional details under Office Visit. 
If I prescribe medications

We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.

If refills are needed in the future, you can:
  • Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
  • Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
If lab testing or imaging is needed

For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the Radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.

If I refer you to another specialty colleague

If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.

If surgery or a procedure is a treatment option

I will recommend you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.

If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a preoperative medical evaluation that will assure that you are properly prepared for your surgery.

Convenient Resources for You

As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.

My Doctor Online is available at any time that is most convenient for you. From my home page you can:

Manage your care securely
  • View and compose secure e-mail messages.
  • Manage your prescriptions.
  • View your past visits and test results.
  • View your preventive services to see whether you are due for a routine screening or updated immunization.
Learn more about your condition
  • Read about causes, symptoms, treatments and procedures.
  • Find interactive health tools, videos, and podcasts to help you manage your condition.
  • View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
  • Locate health education classes and support groups offered at every medical center.
  • Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.

Related Health Tools:

Podcasts
Videos

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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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