Choroidal naevi can be difficult to distinguish from melanomas, meaning many patients with benign tumours are often referred to hospital eye clinics while urgent treatment of those with melanoma is delayed. Early treatment of choroidal melanoma maximises any opportunities for conserving vision and the eye, possibly preventing metastatic death in some patients. The author describes a new algorithm - MOLES - to highlight the most important indicators of malignancy. Against a backdrop of increasing use of telemedicine and the increasing scope for transferring more of the management of these patients to optometrists in the community, the author suggests that this new system may make it possible for a clinician to diagnose tumours remotely, without the patient having to attend a hospital eye clinic.