small talk new knowledge...iPITS

One of the perks of working with physicians is being able to come away with mind blowing knowledge from a simple conversation in passing. Today I had the pleasure of filling in for a coworker who specializes in Visual Field testing and an optic nerve photography (for the lack of a better reference...) The entire afternoon consisted of 5 patients, one of which had 20/30 vision in both eyes. Her pressure readings were below 20 in both eyes and she had no complaints regarding her vision. After reviewing her chart and finishing her eye exam we walked to the visual field room where I conducted a test of her peripheral vision. Next, I took photos of her optic nerves with and printed them, she asked if I could see her "pit" ... thoroughly confused I asked if she was referencing her a dog? maybe? She laughed and said that she was diagnosed with something called a "pit" in her right eye and wanted to know if I could see it..... I reviewed her HRT photos and noticed what she was describing. Something that resembled a bubble located right on the edge of her optic nerve! She told me that she learned about this pit after visiting an Ophthalmologist about 30 years ago who made her very nervous during the exam when he said to his assistant "Go get my book that lists all the eye diseases!" She told me that after hearing those words she knew for sure that she was going blind, but here she is 30 years later .. Ironically with 20/30 vision in both eyes!
During a break in clinic, I asked her physician about the infamous "pit" and how common it was.. is it congenital.... does it effect vision.... how many cases of pits had he seen in his career etc
He informed me that it is congenital and potentially can have a negative effect on vision leading up to worse case scenarios of a retinal detachment. He has seen about a dozen in his career of 25+ yrs at this practice. I did a little research (typed in optic disc pit in Wikipedia) and learned that it can contribute to PVD which is short for posterior vitreous detachment which is commonly called "floaters" or "black spots" people see in their field of vision.(sometimes associated with flashes of light which may indicate a retinal detachment)  It may potentially be hereditary as I'm guessing there were cases of parents and their children having optic disc pits but I am not sure how much research has been done about that aspect of this diagnosis specifically. The pit is a malformation of the optic nerve due to the embryonic fissure closing completely. Usually asymptomatic and usually only being in one eye. Common in about 1 in 10,000 people.. So if you are ever diagnosed with having one.. consider yourself lucky...!?   


next post ... Aniridia!