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Figure 1	Figure 2	Figure 3

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

A 48-year-old white male complained of flashes in center of his right eye field of vision. He was diagnosed elsewhere as having a choroidal nevus and observation was advised. The patient came for a second opinion. The patient’s father had undergone treatment for skin melanoma. On examination, his best corrected visual acuity was 20/40 in right eye and 20/20 in left eye. Anterior segment examination was unremarkable in both eyes. Fundus examination was normal in left eye and the figures above show the fundus picture, fluorescein angiography (FFA) and ocularcoherence tomography (OCT) scan through the tumor [Fig 1, 2, 3]. B scan measured the lesion dimensions as 6mm x 6mm x 1.6mm.

1.	What is your clinical diagnosis?
	a. choroidal nevus b. choroidal malignant melanoma c. choroidal metastasis d. optic disc melanocytoma
2.	How would you manage this case?
	a. observation b. plaque radiotherapy c. enucleation d. trans-pupillary thermotherapy

For answers to the above, click here on or after December 9, 2008.