Holy crap

40 Year-old patient presents for routine examination at 8 AM.  Quick refraction, quick anterior segment.  Ask the patient about dilation- patient is quite hesitant (had a golfing match).  Patient remits and allows dilation; on the last view in the mid-periphery there was a horrible looking, elevated, choroidal nevus.  Something like this:

 Patient had a 4 year history at the clinic with 2 prior dilations, both of which did not mention the lesion. Took photos in office, referred out to ophthalmology for B-scan and fluorescine angiography the same day.  Angiography showed sentinel vessals and B-scan showed elevation.  6AM the next morning, patient is on a plane to the Moran Eye institute in Utah.  They run multiple cancer panels, and have 5 independent retinal specialists view the lesion.  Tests prove negative, and all give diagnosis of benign.  Patient comes home and goes to golf course.