Author : Dr. Sheldon Fernandes Ophthalmology Resident, Co- Author : Dr. Shubha Nagpal Professor & Head Dept of Ophthalmology Bharati Vidyapeeth University Medical College, Pune.

1. Author : Dr. Sheldon Fernandes
Ophthalmology Resident
Co- Author : Dr. Shubha Nagpal
Professor & Head
Dept of Ophthalmology
Bharati Vidyapeeth University
Medical College, Pune
UNILATERAL DISC ANOMALY: MORNING
GLORY SYNDROME

2. PURPOSE
• To report a rare case of optic disc anomaly.
• Incidence : 1 in 10 million.

3. PRESENTATION
40 year old female presented with:
• Deviation of the right eye with loss of vision
noticed around 10 years ago.

4. OPHTHALMIC EXAMINATION
RIGHT EYE LEFT EYE
BCVA PL negative 6/9
AR -5.50/-0.75x30 -1.50 DC at 90ᵒ
IOP (GAT) 16 mmHg 14 mmHg
AXL 25.00mm 22.36mm
ANTERIOR
SEGMENT
Exotropia 150-200.
Pupils 5mm, not reacting to light.
Rest NAD
Orthophoric.
Pupil 2mm, reaction normal.
Rest NAD.

5. FUNDUS
RIGHT EYE
LEFT EYE
•Large funnel-shaped excavation in optic disc.
•White, elevated, hyperplastic glial tissues, occupying the
central disc.
•Abnormally narrow, straight vessels, radiated from the disc
margins.
Within normal limits.

6. USG B SCAN
RIGHT EYE LEFT EYE
Deep Excavated Cup
Within Normal Limits

7. DISCUSSION
• Morning Glory disc is defined as an enlarged disc with
a funnel shaped excavated peri-papillary region that is
surrounded by a wide elevated annulus of chorioretinal
pigment, with a central white tissue and retinal vessels
that exit at the edge of the disc and run radially
towards the peripheral fundus.1
• Etiology - poorly understood.
• Associations - Transphenoidal basal encephalocele
- Midfacial malformations.2

8. • Sex >
• Incidence - 1 in 10 million.
• Visual acuity - 6/6 to counting fingers.
• Amblyopia in Unilateral cases.
• Strabismus may also be present.2
• Visual field defects - enlarged blind spot.2,3
• Serous Retinal detachment – in 30%.4

9. • Differential diagnosis - Optic nerve coloboma
- Peripapillary staphyloma.2
• Treatment is directed towards preventing and treating
the complications (Retinal Detachment).3
• Research is being performed to explore the
possibilities for the treatment and prevention of this
disease.4

10. REFERENCES
• 1. Brodsky, M.C. 2010. Congenital Optic Disc Anomalies in
Pediatric Neuro-ophthalmology. 2nd ed. New York:
Springer.
• 2. Lee, BJ and Traboulsi, EI. 2008. Update on the Morning
Glory Disc Anomaly. Ophthalmic Genetics 29:2, p47-52.
• 3. Kindler P. Morning glory syndrome: unusual congenital
optic disk anomaly. Am J Ophthalmol. 1970; 69(3):376-384.
• 4. Dovemedcom. 1. DoveMed. [Online]. Available from:
http://www.dovemed.com/morning-glory-
syndrome/ [Accessed 13 July 2016].