An optical ophthalmic treatment apparatus including an binocular observation optical system to observe an eye to be operated through a stereo microscope and a laser beam transmitting optical system to transmit a therapeutic laser beam emitted from a laser source onto the eye, the laser beam transmitting optical system comprising an irradiation area confining member capable of controlling an aperture diameter thereof, a projective lens for projecting an aperture image of the irradiation area confining member onto an affected part of the eye to be operated, a laser beam reflecting member for reflecting the optical axis of the laser beam transmitting system so as to be coaxial with the optical axis of an objective lens, and a condenser member for condensing the therapeutic laser beam at a position close to the laser beam reflecting member, the condenser member being arranged in the side of the laser source with respect to the irradiation area confining member.