The Morning Glory Blooms – Morning Glory Syndrome with Contractile Optic Disc



Morning Glory Syndrome is a well-established entity with early descriptions seen in 1900 AD. It results from an abnormal closure of embryonic ocular fissure allowing herniation of retinal and optic nerve head tissue leading to excavation of optic disc. It consists of funnel shaped excavated optic nerve head with an annulus of chorio-retinal pigmentary disturbances. Multiple, narrow and straightened retinal vessels are seen emerging from the optic nerve head in a spoke like manner. It is frequently associated with white fibrous tissue overlying the di sc. Rarely the optic disc in Morning Glory Syndrome exhibits contractile movements during which the change in size of the disc is seen. This is postulated to be due to presence of smooth muscle cells in the coloboma and anomalous communication between the subretinal and subarachnoid spaces. A 38 years old male presented with decrease of vision in right eye associated with outward deviation of right eye. His best corrected visual acuity was 20/60 in right eye. On fundus examination, he was found to have a colobomatous disc. The optic disc was seen to change its size during the examination. The submitted photo is a collage of 3 retinal photos showing the optic disc in fully contracted, fully enlarged and a mid-phase.



Sangeet Mittal
Jalandhar, India
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