PURPOSE: To propose the use of optical coherence tomography as an effective diagnostic tool for identifying macular edema in patients with asteroid hyalosis obscuring the fundus view. DESIGN: Case report. METHODS: Review of clinical chart and images. SETTING: Private retina practice. PATIENT: One patient diagnosed with diabetic retinopathy and asteroid hyalosis, who was experiencing decreased visual acuity and whose fundus view was inadequate for diagnosis using customary techniques. RESULTS: Usual methods of diagnosis were ineffective until OCT obtained a clear image of the fundus and subsequent macular thickening with vitreomacular adhesion. CONCLUSIONS: Optical coherence tomography is an effective diagnostic tool for discovering macular edema in cases of dense asteroid hyalosis where traditional methods fail to obtain a clear image of the fundus.