The differential diagnosis of uveal melanoma includes a wide variety of tumors and several nonneoplastic entities. A systematic diagnostic approach is required, which includes localization of the lesion within various ocular tissues, identification of secondary effects in adjacent tissues, expert interpretation of imaging studies, and, in selected cases, tumor biopsy. It can be difficult to differentiate small choroidal melanomas from nevi. The first author (BD) has devised the “MOLES” acronym and scoring system to distinguish choroidal nevi from melanomas according to mushroom shape, orange pigment, large tumor size, enlargement, and subretinal fluid. This does not require ultrasonography and therefore complements the TFSOM-DIM mnemonic.