Sclerochoroidal calcification with slow enlargement in all dimensions over 13 years

Sclerochoroidal calcification is a benign calcific deposition that rarely exhibits growth over time. A 68-year-old white male was found to have an amelanotic lesion in his right eye suspicious for choroidal melanoma. Fundus evaluation showed a deep yellow mass measuring 5 × 4 mm at the base (Fig. 1A). Ultrasound demonstrated an echodensity with a thickness of 3.5 mm consistent with sclerochoroidal calcification (Fig. 1B). Examination of the left eye was unremarkable. Parathyroid hormone, vitamin D, and electrolytes were within normal limits. At 13 years of follow-up, the mass in the right eye had enlarged in all dimensions, measuring 9 × 7 mm at the base (Fig. 1C) and 4.9 mm in thickness (Fig. 1D). Optical coherence tomography (Fig. 1E) showed a classic “table mountain” lesion confined to the sclera and with irregular compression of the overlying choroid, confirming the diagnosis of sclerochoroidal calcification. Continued observation was recommended.