A large body of literature attests to the efficacy of radiotherapy (either external-beam radiation therapy (EBRT) or episcleral plaque therapy) in the treatment of medium-sized choroidal melanoma. The COMS trial for medium-sized melanomas (discussed in detail below) concluded that sight-conserving brachytherapy does not adversely affect survival outcomes when compared with enucleation. Since the globe and some vision can usually be maintained, radiotherapy has become the mainstay for sight-preserving treatment of medium- and large-sized choroidal melanoma.