Optic Nerve Pit

Monday, Apr 1, 2024 by Nisha Gupta, MD

This month we will talk about optic nerve pits.

What is an optic nerve pit?

An optic nerve pit is a small gray-white cavity of the optic disc. It is a rare abnormality that occurs when the eye does not develop properly before birth. Most occur in one eye, but they can be seen in both eyes. They affect men and women equally and there are no known risk factors.

What are the symptoms?

Most patients do not have symptoms, and these are found on routine exam. The vision may be affected if the macula is involved. Fluid can collect in the layers of the macula causing swelling or separation of the layers. If this occurs, the central vision becomes blurry, and one may notice distortions or a blind spot in the vision.

How is it detected?

A comprehensive exam including checking the vision and dilating the eyes is needed to see the optic pit. A visual field test can be done to check peripheral vision. An OCT, optical coherence tomography, shows if there is fluid in the retinal layers.

Posterior subcapsular cataract

The arrow points to the optic nerve pit. Image Source1

Posterior subcapsular cataract

The arrow is pointing to fluid that has collected between the retinal layers. Image Source1

What are the treatments?

There is no cure for an optic pit and treatment is usually only needed if the macula is affected. Laser can be performed to stop the fluid from moving further into the center of the macula but is not always effective. Surgery can be done if there is a retinal detachment.

Return next month for a discussion on a new topic!

  1. Images courtesy of Nisha Gupta, MD [return]

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