What is an optic nerve pit?

An optic nerve pit is a back protrusion of tissue seen on the optic nerve. It’s hard to notice; in fact, most people don’t realize they have a pit until an ophthalmologist observes the pit during an exam.

Optic nerve pits are uncommon. An early report found it occurred in about 1 in 11,000 patients. They are innate, which means people are born with them. Most people only have one eye, but 15% have optic nerve pits in both eyes. Men and women are equally affected by the optic nerve pit.

This article will explain in detail what an optic nerve pit is, its symptoms, diagnosis, and available treatments.

structure and reason

Your optic nerve, also called cranial nerve 2 or CN 2, connects the retina, which is located at the back of your eye, to your brain. It is responsible for transmitting visual information (what you see) from the retina to the brain. The optic nerve consists of more than one million nerve fibers.

The optic nerve pit, also called the optic disc pit or sometimes the optic foramen, is thought to be a pocket or defect located within the optic nerve.

Optic nerve pits may occur due to incomplete formation of the eye in the embryo (an early stage of human development, when the organ is formed). Researchers debate the exact cause of the optic nerve depression.

Optic Pit Symptoms

Many adults with optic nerve depression have no symptoms, and children rarely experience symptoms. If vision changes do occur, they are more likely to occur in a person’s 20s or 30s. Vision changes cause depression of the optic nerve in about 50% of people.

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Vision changes are caused by fluid buildup under the macula. The macula is the central part of the retina. The accumulation of fluid under the macula in the retina without rupture is called serous retinal detachment. Severe retinal detachment can cause:

  • blurred vision
  • Blind spot in vision
  • see objects smaller than they actually are
  • Treat straight lines as curved

Retinal detachment is considered a medical emergency.Vision problems involving the macula and associated with the optic fossa are often referred to as macular degeneration.

The retina and the fluid behind your vision

Diagnosing optic nerve pits

Optic nerve pits cannot be detected by looking at the eye alone.

Many people with optic nerve pits do not notice any changes in their vision. The most common method of detection is during routine eye exams. During these exams, an ophthalmologist may notice optic nerve pits when examining the optic nerve and retina.

An ophthalmologist can observe the optic fossa directly or indirectly ophthalmoscope. This involves using a hand-held or head-worn device to help the doctor see the back of the eye.

Ophthalmologists can also Slit lamp biomicroscope binocular examination. A slit lamp is a special microscope with a strong light attached. This tool allows professionals who specialize in examining your eyes to take a closer look at the structures in front of and inside your eyes.

An ophthalmologist can also perform a visual field test, which measures your entire field of vision​​. This will help them see if there is a visual field defect due to the optic nerve pit.

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Could it be something else?

During the exam, doctors can help confirm whether what is found is actually an optic nerve pit or another congenital anomaly, such as a defect in the optic disc or a morning glory anomaly. These may have a similar appearance.

Optic nerve pits can also resemble glaucoma, a group of eye diseases that cause damage to the optic nerve and vision loss. Your eye doctor can also rule out glaucoma during the exam.


People with optic nerve pits do not need treatment if they do not have any vision symptoms caused by them. An ophthalmologist may simply recommend monitoring and returning for regular eye exams.

If the macula has fluid buildup associated with serous retinal detachment, the eye will need treatment. These treatments may include:

  • Surgery: An ophthalmologist can perform several types of surgery for the optic nerve pit.The most common one is called pars plana vitrectomy. Sometimes surgery alone, sometimes in combination with other treatments. This type of surgery has shown improved vision in more than 50% of patients with optic nerve depression. It also often successfully reconnects the retina in the event of a complete retinal rupture.
  • inject gas stuffing: This involves the use of gas injected into the eye during retinal surgery to help repair retinal detachments. This procedure typically removes 50% to 75% of the fluid. However, re-injection of gas is often required due to fluid return.
  • inner retina window: This method creates a channel that allows fluid under the macula to drain and flow towards grass. The vitreous is the gel-like fluid in the eye. This method can help resolve fluid buildup and improve vision.
  • Laser photocoagulation: This treatment uses a special laser to prevent fluid from entering the macula. However, this treatment has a lower success rate than other treatments for optic nerve pits.

Treatment outcomes for optic nerve pits can vary. If macular degeneration is present, vision may drop to 20/200 or worse (normal vision is 20/20) in about 80% of patients. However, the success rate of surgery is about 87%.

In some people, vision does not return to normal despite treatment.


Optic nerve pits are birth defects near the optic nerve that occur in about 1 in 11,000 people. It more commonly affects one eye rather than both. Most people don’t know they have it until an eye doctor observes the pit during an exam.

Optic nerve pits usually do not require treatment and do not cause visual effects. When it does cause vision changes due to macular degeneration, treatment options include various surgeries. Surgery can help improve vision, although some people may not regain normal vision even after treatment.

VigorTip words

If your eye doctor tells you you have an optic nerve pit, follow any instructions on how often you should return for an eye exam. These tests give your doctor an opportunity to monitor optic nerve pits and increase your chances of getting good vision. Talk to your doctor about your long-term risk of developing macular degeneration. Tell your healthcare team if you have any changes in your vision.

Types of Ophthalmologists