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Bertil Damato, MD, PhD, FRCOphth; Sarah E. Coupland, MBBS, PhD, MRCPath

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The controversy regarding uveal melanoma genetic prognostication deserves comment.^1-3

Shields et al² rightly encouraged early treatment of small melanomas because 27% of these show monosomy 3 and high metastatic potential. Treating all small melanomas causes excessive morbidity, but observation risks shortening life. Biopsy helps resolve this dilemma, justifying low rates of complication and inconclusive results.

Shields et al² observed that tumor size is a poor predictor of metastasis. Cytogenetic tumor typing identifies high-risk patients meriting recruitment into trials of any promising adjuvant systemic therapies. Such studies would otherwise require impossibly large patient numbers.⁴

Tsai and O’Brien³ warned that patients' quality of life is diminished by a poor prognosis. This is untrue.⁵ They express caution for the false sense of security provided by a good prognosis; however, metastasis is rare with disomy 3 melanoma, especially if multiple predictors are analyzed.^6-7 . . . [Full Text of this Article]

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