The diagnosis can be made based on the hemispherical protrusion of the mass from the bulbous wall into the vitreous and the “choroidal depression sign”, combined with the clinical history and other ancillary examinations. Ultrasound can provide important information for the diagnosis of choroidal melanoma, and in combination with other imaging examinations, can provide a correct or valuable suggestive diagnosis of choroidal melanoma. In fundus fluorescence imaging examination, choroidal melanoma can affect its fluorescence intensity due to the size of the tumor, the amount of pigment and blood vessels, the degree of leakage, and the presence of tumor necrosis and retinal destruction, etc. The tumor with more pigment and fewer blood vessels shows weak fluorescence, and vice versa shows strong fluorescence. When the refractive interstitium is unclear, imaging is essential once choroidal or ciliary body melanoma is clinically suspected, the most valuable being ocular ultrasound and magnetic resonance presentation. In particular, ocular ultrasonography is irreplaceable to other tests for its diagnosis, differential diagnosis, biometry of the mass, choice of treatment, and observation of the efficacy to determine the prognosis. Furthermore, combined with the special manifestations of standardized type A ultrasound probing choroidal melanoma, namely (1) solidity; (2) sudden rise of tumor surface waves; (3) internal hyporeflectivity; and (4) rapid spontaneous motion of pathological waves, the ultrasound attenuation of choroidal melanoma is remarkable, while other intraocular tumors lack this ultrasound feature, all of which greatly help in the ultrasound diagnosis of choroidal melanoma. Therefore, in clinical practice, fluorescein fundus angiography and ophthalmic ultrasound should be combined with each other and complement each other to provide strong evidence for the diagnosis and differential diagnosis of choroidal metastatic tumors. To improve the diagnostic criteria, it is still necessary to combine medical history, systemic examination and other ocular ancillary examinations, and FFA and ultrasound examination can clearly show the lesion site and development process, which can be used to guide clinical treatment. Small tumors can be followed up and observed or treated with local excision, laser photocoagulation and radiotherapy. Ophthalmopexy is still the main treatment option and is indicated when the tumor continues to develop and the tumor in the posterior pole involves the optic nerve. Larger tumors may lead to blindness or secondary glaucoma or retinal detachment.