They often appear as small, hypopigmented, yellow or whitish, oval or round excavated defects, most often within the inferior temporal portion of the optic cup. The optic disc in these patients appears larger than normal, and 60 percent of discs with optic pits also have cilioretinal arteries. These patients have a greater propensity to develop normal-tension glaucoma.
Most patients are unaware of the presence of an optic pit.
Although as many as 60 to 70 percent of patients with optic pits possess some arcuate scotoma corresponding to the loss of retinal ganglion cells, their acuity is rarely affected. Patients may notice visual distortions, metamorphopsia or blurred vision. Those with temporal pits have the greatest risk for developing serous maculopathy. The origin of optic pits remains unclear. Optic pits have been associated with colobomatous lesions, suggesting that they result from incomplete closure of the fetal fissure.