To report differences in the coloration of fundus lesions between Asian and Caucasian patients with bilateral diffuse uveal melanocytic proliferation (BDUMP). This syndrome was detected in 2 Japanese patients, 69 and 73 years old, with lung cancer who visited our department complaining of visual disturbances. The coloration of the fundus lesions was investigated in these 2 patients. The fundus lesions in the first patient appeared gray or grayish-brown in color at the first visit. Six months later, the fundus appeared as a mixture of white to dark-brown lesions. The fundus in the second patient exhibited a mixture of white, gray, and dark-brown lesions from the first visit. The fundus lesions in these BDUMP patients appeared gray or grayish-brown in color at the early stage of the disease, probably because of the abundance of melanin pigments in the uveal melanocytes. At the advanced stage, the fundus exhibited a mixture of dark-brown lesions due to melanin deposits and white, depigmented lesions caused by atrophy and/or necrosis of the melanocytes.