An asymptomatic 96-year-old white male with a history of hypertension, atrial fibrillation, basal cell- and squamous cell carcinoma of the scalp, and vitamin B12 deficiency presented for a routine eye exam. His last eye exam had been 13 months prior and was unremarkable. His best-corrected visual acuity was 20/20 right eye (OD), 20/20 − 2 left eye (OS). Fundus examination of the left eye revealed a darkly colored choroidal elevation without subretinal fluid, drusen or orange pigment in the superotemporal midperiphery, measuring 6 × 6 × 1.5 mm. The lesion was isoautofluorescent relative to adjacent structures. B-scan showed a dome-shaped, elevated acoustically-solid choroidal lesion with no extrascleral extension. It flattened with increased external pressure applied to the globe, consistent with benign a vortex vein varix and excluding other differentials, such as melanoma or other solid lesions. Optical coherence tomography (OCT) scans were consistent with a vortex vein varix superotemporally, indicating thickened choroidal vessels causing elevated RPE contour with normal overlying retina. During a 9-month period of observation, this lesion remained largely stable clinically and showed comparative shallowing by OCT. At a visit thirteen months from the initial evaluation, the elevated vortex varix had entirely flattened, even when the patient looked superotemporally. There was no recurrence during an additional 3-month interval.