Posterior Segment
Choroidal Osteoma
Also known as: choroidal osteoma, osseous choristoma of the choroid, ossifying choroidal tumour, calcified choroidal lesion, juxtapapillary yellow lesion
Filed as: Routine
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
Choroidal osteoma is a rare benign bone-forming tumour of the choroid. It is usually in one eye, beside the optic disc or at the macula, slightly raised, with an irregular outline and a fine network of vessels on its surface. Its colour changes over time from yellow-orange to yellow-white. Complications are RPE disruption, photoreceptor atrophy, subretinal fluid and choroidal neovascularisation. The optometry role is to document and image it, review it routinely, and refer when the diagnosis needs ultrasound or a complication appears.
Recognition
Symptoms: what patients report
- Often none when the lesion is away from the fovea.
- Gradual blur or a scotoma when the macula is involved.
- Sudden distortion or a drop in vision raises concern for choroidal neovascularisation.
Signs: what the examination shows
- A yellow-orange to yellow-white, slightly raised lesion with an irregular but distinct margin, beside the disc or at the macula.
- A fine vascular network on the lesion surface.
- OCT: altered choroidal architecture under the lesion, with the retinal layers preserved unless a complication develops.
- Fundus autofluorescence varies with the degree of calcification, atrophy and any fluid or neovascularisation.
- B-scan ultrasound shows a strong acoustic shadow and may be needed to make the diagnosis.
What OptoGuide™ covers for choroidal osteoma
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked Australian therapeutics
- Referral urgency, specialty, and letter drafting