Myopic patients more than -6 diopters may suffer from this newly recognized pathology previously termed peripapillary detachment in pathologic myopia. It affects 5 % of highly myopic eyes. Usually a yellowish round lesion can be observed inferiorly to the optic nerve during fundus examination. We described that complex forces like posterior expansion force, vitreous traction force, and vitreous fluid dynamics determine the size and shape of the lesion. In the OCT intrachoroidal an hyporeflective cavity can be observed in the tissue of Jacoby space. Another OCT finding, macular intrachoroidal cavitation, had OCT features similar to peripapillary intrachoroidal cavitation and has relation with patchy atrophic areas at the posterior pole also in myopic patients. This pathology does not require any special treatment but should be recognized by ophthalmologists so as to avoid unnecessary tests to the patient. We present a case of 54 a year old woman who asked for a second opinion because she was diagnosed with a “small optic nerve tumor on the right eye”. She had -7 and -8 diopters in both eyes. She was recommended for brain magnetic resonance and ocular ecography. The patient did not describe any ocular symptom or reduced visual acuity. During fundus examination a yellowish peripapillary lesion could be observed inferiorly to the optic nerve and we performed an OCT to study of the optic nerve area. The OCT showed a round hyporeflective cavity in the lower part of the optic nerve so PERIPAPILLARY INTRACHOROIDAL CAVITATION was confirmed. Differential diagnosis should be made with optic nerve pit, optic nerve colobomas o peripapillary small tumors. This is an infrequent pathology that should be recognized by ophthalmologist to avoid misdiagnosis with other peripapillary pathologies. This will avoid performing unnecessary additional test and provides peace of mind to the patient. Images of the optic nerve and OCT images illustrate the case.