Fig. 1. Clinical risk factors for growth of small choroidal melanoma. (TFSOM = To Find Small Ocular Melanoma represents factors of Thickness over 2 mm, subretinal Fluid, Symptoms, Orange pigment, and Margin of tumor at optic disc) A. Thickness greater than 2 mm. Perimacular small choroidal melanoma measuring 2.9 mm in thickness and with overlying orange pigment and subretinal fluid, manifesting as retinal striae. B. Thickness greater than 2 mm. Optical coherence tomography demonstrating subfoveal fluid in the patient in A. C. Subretinal fluid. Sixteen-year-old patient with documented enlarging small choroidal melanoma and shallow subretinal fluid. D. Subretinal fluid. Optical coherence tomography demonstrating subfoveal fluid in the patient in C. E. Symptoms. Small choroidal melanoma producing symptoms of blurred vision from subfoveal fluid. Note the overlying orange pigment. F. Symptoms. Small choroidal melanoma located superiorly with trough of subretinal fluid in the foveola producing symptoms of metamorphopsia. G. Orange pigment. Macular choroidal melanoma with prominent overlying orange pigment and a rim of subretinal fluid. H. Margin at the optic disc. Minimally elevated small choroidal melanoma touching the optic disc. I. Other features. Juxtapapillary small choroidal melanoma with overlying orange pigment, shallow subretinal fluid, and irregular margins suggestive of tumor activity.