In Brief:
Necrotic uveal melanoma can present with atypical features, including hemorrhagic retinal and choroidal detachment, diffusely dark choroid on transillumination, absent spontaneous vascular pulsations on ultrasonography, and hyperintense hemorrhage on T1-weighted magnetic resonance imaging, preventing detection of the tumor. Intraocular malignancy must be considered in patients with spontaneous hemorrhagic retinal and choroidal detachment.