Returning to Work on Machinist with Centra Serous Chorioretinopathy: A Case Report

Introduction. Central Serous Chorioretinopathy (CSCR) is one of the four most common retinal diseases after macular degeneration, diabetic retinopathy, and retinal vein occlusion that can directly impact the visual function of workers. CSCR is characterized by retinal detachment of the pigment epithelium in the macula due to fluid flow from inadequate hyperpermeability of the choriopapillary and epithelial membranes. The etiology and pathogenesis of CSCR are multifactorial, including genetic, pregnancy, psychosocial stress, glucocorticosteroid use, sleep disorder, and irregular work schedule. Methods. The male patient, 33 years old, working as a train driver was consulted regarding his fitness to work after being declared with a diagnosis of resolved bilateral CSCR. He has the main task of operating the train and alert process as well as the leader in train travel. He was diagnosed with CSCR when he was found to have decreased visual acuity at a periodic medical examination. Result. Fit with Note (Restriction) as train driver If symptoms appear with the least possible symptom intensity, immediately report, consult, and get treatment. Assistance by assistant driver during on duty, No overtime, long-working hours, or on-call duty. Discussion. Literature was searched through PubMed and Scopus. Five relevant articles were found and had undergone critical appraisal based on criteria by the Oxford Centre for Evidence Based Medicine. Return to work assessment was conducted using the seven steps of return-to-work evaluation issued by IOMA (Indonesian Occupational Medicine Specialist Association). Examinations and several notes at workplace will be used to ensure the patient's ability to return to work. Conclusion. The employee, who has been cured from CSCR, has potential recurrence because of working risks. Adjustments and preparedness in the working area, education to the patient, family, and office management are needed while returning to work.