Posterior Segment
Sclerochoroidal Calcification
Also known as: sclerochoroidal calcification, sclero-choroidal calcification, idiopathic sclerochoroidal calcification, scleral calcification, yellow placoid peripheral lesions, superotemporal yellow lesions
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
Sclerochoroidal calcification is calcium deposited at the level of the sclera and choroid. It appears as several discrete yellow plaque-like lesions, typically in the superotemporal fundus behind the equator. On OCT the sclera rises under the lesion and compresses the choroid above it. It can accompany conditions that alter calcium and phosphate metabolism. The optometry role is to recognise it, tell it from a choroidal tumour, review it routinely, and ask the GP to screen for a metabolic cause.
Recognition
Symptoms: what patients report
- None; an incidental finding, usually in an older adult.
- Vision is not affected.
Signs: what the examination shows
- Multiple discrete yellow or yellow-white placoid lesions, most often superotemporal and behind the equator, commonly in both eyes.
- OCT: a mountain-like rise of the sclera beneath the lesion, with a flat, rolling, rocky or table-shaped profile, a thinned choroid over it, and RPE change.
- Fundus autofluorescence: the lesions match the background or are bright.
What OptoGuide™ covers for sclerochoroidal calcification
- 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
Sources
- Centre for Eye Health — Chair-side Reference: Hypo-Pigmented Posterior Lesions
- Shields CL et al. Sclerochoroidal calcification: clinical features, outcomes, and relationship with hypercalcemia and parathyroid adenoma in 179 eyes. Retina 2015;35:547-54 (hyperparathyroidism 27%, Gitelman syndrome 11%; evaluate for parathyroid and renal metabolic conditions)