Optic pits are rare congenital abnormalities of the optic nerve head, with a prevalence of 1 per 11,000. Macular retinal detachment occurs in 25% to 75% of these patients. Managing the chronic macular detachments in these cases remains controversial and challenging. Available treatment options include observation, laser photocoagulation, and vitrectomy with or without internal limiting membrane peeling with gas tamponade. However, none are universally effective. In this video the authors describe a novel surgical technique: After vitrectomy, an autologous scleral graft harvested from the patient's same eye is used to patch the opening of the optic nerve head pit, which yields good results. According to the authors, the technique appears to be effective, safe, and easily reproducible.