Consideration of ocular anesthetic techniques and anesthetic choice plays a critical role for the success and safety of ophthalmic surgery.

This report describes the de-novo appearance of a choroidal osteoma in an eye, following years after laser photocoagulation for previous branch retinal vein occlusion (BRVO). A 62-year old male presented with an asymptomatic yellowish-orange lesion in the macula on fundus examination of his left eye, during a regular follow up visit for bilateral BRVO associated with macular edema, which had been treated with laser photocoagulation many years ago. The lesion was observed for 1.5 years until decrease in vision occurred. Fundus photography revealed a yellow-to-orange, well-defined lesion in the macular region. Fluorescein angiography was consistent with choroidal neovascularization (CNV). OCT and B-scan ultrasonography showed features consistent with choroidal osteoma. This is the first report of the de-novo appearance of a choroidal osteoma in an eye, following years after laser photocoagulation for BRVO. CNV developed secondary to the lesion, which was treated with intravitreal Bevacizumab, leading to subjective and anatomic improvement.