Bilateral choroidal haemangioma in an otherwise normal middle aged female

Circumscribed choroidal hemangioma is a rare benign vascular tumor. It is of two types, circumsribed and diffuse. Circumscribed choroidal hemangioma is a well demarcated solitary lesion, usually situated posterior to equator, while diffuse have ill defined thickening of choroid involving more than one zone or quadrant. Patient may present with progressive diminution of vision, metamorphopsia, floaters and visual field defect. The visual symptoms are because of associated subretinal fluid, cystoid macular edema, and in long standing cases, retinal pigment epithelium changes, subretinal fibrosis and retinoschisis. It must be distinguished from amelanotic melanoma and choroidal metastasis. Investigation such as ultrasound, optic coherence tomography, fundus fluorescein angiography, indocyanin green angiography can be used to confirm the diagnosis. Multiple treatment options like transpupillary thermotherapy, photodynamic therapy, plaque brachytherapy and external beam radiotherapy.