THE difficulties of the differential diagnosis between haematomata under the retinal pigment epithelium, degenerative diseases of the macula, and malignant melanomata of the choroid have often been pointed out (Reese and Jones, 1961). These problems have troubled many an eye surgeon and their solution will not be discussed here, but a modification of the usual method of enucleation to be used when removing an eye possibly containing a malignant tumour is described below. In these cases the implantation of any type of metal, glass, or plastic ball into the muscle cone is contraindicated, but if subsequent study of the enucleated eye shows that there is no probability of a recurrence, an implant may be inserted at a later date. To facilitate such delayed implantation and also to inspect thoroughly the muscle cone at the time of the enucleation it is advisable to secure the tendons of the four recti muscles. Otherwise these will contract after severing and become difficult to find when needed later to supply motility for a secondary implant. The early steps of this modified enucleation do not differ from the typical procedure: After incision of the conjunctiva along the corneal limbus and exposure of the recti muscles using blunt curved scissors, three musclesusually the inferior, temporal, and superior-are caught with a strabismus hook in the usual manner. Before severing the tendons, a black 4-0 doublearmed silk or nylon suture is introduced into each of the two outer thirds of each tendon. While an assistant holds the suture away from the scissors, the surgeon severs the tendon in the usual way. The needles are then led through Tenon's capsule and out of the conjunctiva, about 1 cm. away from the conjunctival incision; the ends of the threads are knotted but are not cut until after inspection of the muscle cone. It may be advantageous to put over each needle a small glass bead about 1 mm. in diameter which should remain in the tissue to prevent the muscle from shrivelling and to make it easier to find later when an implant is to be inserted (Fig. 1, opposite). The bulbar insertion of the fourth tendon, usually the nasal, should be left longer for easy grasp by the enucleation forceps; the tendon should be sutured to