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BACKGROUND
Malignant melanoma of the choroid is the most common ocular primary malignancy, but is still a rare tumour. The occurrence of bilateral uveal melanoma is exceedingly rare. The probability of any one individual developing bilateral melanoma is estimated to be 1 to 50 million.

MATERIALS AND METHODS
A retrospective search of the photo database of patients between 1970 and 2006 with uveal melanoma was performed.

RESULTS
Four patients with bilateral melanoma were identified. The case reports of the two females and two males are presented.

CONCLUSIONS
In summary, bilateral primary uveal melanoma seems to occur more frequently than expected. The estimated probability for patients with unilateral primary uveal melanoma of developing bilateral melanoma is 0.2 %. In single cases the interval between the occurrence of the second melanoma can be more than 30 years. In patients with a history of malignant melanoma of the choroid it is important to carefully observe the other eye life-long.