Optic pits are small, hypopigmented, yellow or whitish, oval or round, excavated colobomatous defects of the optic nerve; they are usually found within the inferior temporal portion of the optic nerve head margin (Fig 16-19). Most are unilateral, asymptomatic, and congenital, but they can be acquired in the setting of glaucomatous excavation. Optic pits may lead to serous macular detachments with a poor prognosis if left untreated. The macular retinal thickening and detachment typically extend from the optic pit in an oval shape toward the fovea. OCT imaging reveals macular schisis as well as subretinal fluid. Whether the subretinal fluid is liquid vitreous or cerebrospinal fluid is controversial; a proteomic analysis of fluid in 1 adult case confirmed that vitreous was the definite source. Optic pits are among the few conditions associated with macular schisis. Various successful treatments have been reported, involving vitrectomy with gas-bubble placement.