This 66YO female presented with an asymptomatic left optic nerve coloboma with a large temporal pit. The mildly colobomatous portion of the nerve is enlarged and slightly excavated inferiorly. Vision was 20/25 OD and 20/200 OS. Observation was recommended.
Learning Points:
Optic pits are most commonly located within or along the inferior-temporal disc margin and usually appear as a gray depression. They are thought to be caused by incomplete closure of the optic fissure during gestation.
While most optic pits are asymptomatic (as in this case), they can cause vision loss by forcing fluid into the inner and outer retina and, ultimately, the subretinal space (optic pit maculopathy).
The source of the fluid remains a subject of ongoing debate, with origins in either the vitreous or the subarachnoid space.
