This 36YO male presented with an asymptomatic anomalous right optic nerve coloboma with a large temporal pit.
The superior portion of the nerve is fairly normal. The colobomatous portion of the nerve is enlarged and excavated nasally, inferiorly, and temporally.
Vision was 20/20 OD and 20/400 OS. He had a history of surgery for a congenital cataract and microphthalmia in his left eye.
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, they can cause vision loss by forcing fluid into the inner retina, outer retina, and, ultimately, the subretinal space (optic pit maculopathy). The source of the fluid remains a subject of ongoing debate, with opinions ranging from the vitreous to the subarachnoid space.
