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Photo courtesy of:  Carol L. Shields, M.D. Used with permission.  Not to be reproduced.

A 29-year-old white woman was referred for the management of a freckle in her left eye fundus. There was a history of breast biopsy done in the past which was benign. Best corrected visual acuity was 20/20 in both eyes. Right eye examination was unremarkable. In the left eye, anterior segment examination revealed subtle episcleral pigmentation. On detailed fundus examination, a mass 3.0x2.8x1.6 mm in size was noticed over the infero-temporal edge of otpic disc. There was a modular component, 1.2x1.2x1.6 mm in the center of the main lesion as shown above.

1.	The most likely diagnosis in this case is:
	a. choroidal nevus, encroaching the optic disc b. optic disc melanocytoma c. choroidal melanoma, encroaching the optic disc
2.	What investigations would you advise for confirmation of the diagnosis?
	a. fluorescein angiography (FFA) b. fine needle aspiration biopsy (FNAB) c. none of the above d. all of the above
3.	The treatment is:
	a. observation and regular follow up b. enucleation c. radiotherapy with a notched plaque

For answers to the above, click here on or after May 20, 2008.