Dome shaped maculopathy (DSM) is a convex anterior protrusion of the macula into the vitreous cavity. DSM is commonly associated with high myopia and posterior staphyloma but can occur in emmetropia. DSM is thought to occur in 12% of highly myopic eyes but the exact population prevalence is currently unknown. The major complication of DSM is serous retinal detachment, likely secondary to subretinal fluid (SRF) accumulation. DSM is an unusual, poorly understood yet relatively common disease that most Ophthalmologists will encounter in their practice.