Senile calcific scleral plaques usually appear as ovoid calcific densities anterior to the medial and lateral rectus muscle insertions. They represent asymptomatic "do not touch" lesions.

Differential diagnosis always includes radio-opaque foreign bodies especially if unilateral or asymmetric in appearance. Consider scleral buckle if there is a history of previous orbital surgical intervention. Trochlear apparatus calcification is in the superomedial orbit.