This healthy 63YO male was referred for cataract surgery in his right eye. He had a lifelong history of poor vision in his left eye. Vision was 20/60 OD and counting vision OS.
Color fundus imaging and OCT of the right eye show a grey inferotemporal optic nerve pit. Marked peripapillary scarring surrounds the left nerve, which is anomalous with an inferotemporal disc coloboma.
Learning Points:
An optic nerve pit and coloboma are cavitated abnormalities that can be a unilateral or bilateral condition and are caused by incomplete closure of the embryonic fissure. While most lesions are asymptomatic, they can cause vision loss by forcing fluid into the inner and outer retina, and finally into the subretinal space (optic pit maculopathy). Our patient currently shows no evidence of this.
Cataract surgery was performed on his right eye, and vision improved to 20/20. Observation for the disc abnormalities was recommended.
