Malignant transformation of optic disc melanocytoma? A clinical dilemma at presentation with a review of the literature.

Malignant transformation of optic disc melanocytoma is an uncommon feature, although in the past a few cases have been reported. Though our case, a healthy 30-year-old female, presented with all clinical features of melanocytoma, the triad of moderate visual loss, elevation of the lesion of 5.2 mm and an atypical ultrasonic picture could be an indication of malignant change at presentation. In the event of a moderate visual loss, long-term follow-up with serial fundus photographs and ultrasonic measurements is necessary for further management.