OBJECTIVE: To describe a case of choroidal osteoma.

METHODS: This is a case report.

RESULTS: A 49-year old female had unilateral, gradual, progressive, painless, blurring of vision. She was previously started on anti-TB treatment because of positive PPD skin test. T-spot test was negative and vision of hand movement persisted in the left eye. Both eyes had yellow, slightly elevated, peripapillary subretinal patches with scalloped margins. Fluorescein angiography revealed bilateral subretinal patchy hyperfluorescence and perifoveal petalloid hyperfluorescence in the left. Macular OCT showed hyporeflective ill-defined sub-retinal pigment epithelial (RPE) lesion in the right eye and a hyporelective well-defined sub-RPE thickening with large cystoid macular edema in the left. B-scan ultrasonography revealed bilateral densely hyperechoic subretinal concave band with posterior shadowing that persisted on decreased gain. These were consistent with bilateral choroidal osteoma with secondary cystoid macular edema in the left eye.

CONCLUSION: Choroidal osteoma is a rare benign choroidal tumor of healthy young women wherein the choroid is replaced with mature bone. It is a clinical diagnosis with characteristic ultrasonographic findings.