Choroidal melanoma presenting as vitreous haemorrhage

Vitreous haemorrhage is an unusual presenting feature of malignant melanoma of the choroid. We describe three cases in which this occurred. The three tumours shared a number of common features: all were located in the peripheral choroid, were of a similar size and had a small herniation of tumour tissue through Bruch's membrane. We believe that vascular congestion caused by constriction of the tumour vasculature at the site of herniation is the most probable cause for the haemorrhage in these cases. We review the relevant literature and discuss some of the commoner differential diagnoses.