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Photos courtesy of: Carol L. Shields, M.D. Used with permission. Not to be reproduced.

An 82-year-old woman was referred for the management of multiple choroidal tumors in both eyes. The patient was treated for skin melanoma 30 years back. Her best corrected visual acuity was 20/30 and anterior segment was normal in both eyes. The fundus picture of both eyes is shown above.

1.	What is your clinical diagnosis?
	d -- sclerochoridal calcification
2.	How would you manage this case?
	a -- observation
3.	How would you evaluate the patient systemically?
	b -- blood levels for calcium, potassium, phosphorus and magnesium levels

Sclerochoroidal calcification is a condition characterized by nearly flat, yellowish white, bright lesions at the choroid level. Choroidal metastases are slightly elevated, yellowish lesions with ill-defined borders. Choroidal Osteoma is unilateral in 80% cases and found in young females in 70% cases. The lesion is yellow-orange in color and it is placoid like with well defined margins, and generally found in peri-papillary area or macula.
Sclerochoroidal calcification is a benign condition and needs no management. Mostly, it is an idiopathic condition, but has been reported to be associated with hyperthyroidism, pseudo-hypoparathyroidism, Bartter and Gitelman’s syndrome, thus needs a systemic work up.


REFERENCES:

1. Shields JA, Shields CL. Sclerochoroidal calcification. Review. The 2001 Harold
Gifford Lecture. Retina 2002: 22: 251-261

2. Shields JA, Mashyekhi A, Ra S, et al. Pseudomelanomas of the posterior uveal tract.
The 2006 Taylor Smith Lecture, Retina 2005:25:767–771.