Malignant Transformation

In this 1-Minute Video, Dr. Carol Shields offers tips for managing patients who present with a pigmented lesion at the back of the eye. Risk factors that predict the transformation of choroidal nevus in melanoma can be remembered with the following mnemonic: To Find Small Ocular Melanoma Doing IMaging. T: thickness over two millimeters; F: fluid; S: symptoms of vision loss less than 20/40; O: orange pigment; M: melanoma halo on ultrasonography and D-I-M: doing imaging for diameter greater than 5 millimeters. Patients with 1 risk factor have an 11% risk—and those with 4 or more risk factors have a greater than 50% risk—that their lesion will be bigger within 5 years. Patients with multiple risk factors should be referred to a local retina specialist or an ocular oncologist for early intervention.