Twenty-four patients (31 eyes) with choroidal folds unassociated with orbital tumors were evaluated with standardized echography. Hypermetropia was the most commonly associated finding (eight eyes); in ten eyes, no consistent abnormal findings could be established. Among the less common causes were swelling of the optic nerve proper or the perineural sheaths and thickened extraocular muscles. Standardized echography demonstrated ocular changes, orbital changes, or both, in all but two patients (two eyes) with idiopathic folds. The most frequent findings were flattening of the posterior ocular wall (18 eyes), thickening of the retinochoroid layer (12 eyes), and distention of the optic nerve sheaths (eight eyes). While fluorescein angiography is well established as the preferred method of demonstrating choroidal folds, standardized echography may now be used to delineate the often subtle associated ocular and orbital findings.