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Images in clinical medicine

A case of morning glory syndrome

A case of morning glory syndrome

Islam Bechakh1,&, Abdelhakim Hammoudi2


1Department of Ophthalmology, Central Hospital of the Army, P.O box 244, Kouba, 16063, Algeria, 2University of Algiers I Benyoucef Benkhedda, 02 Rue Didouche Mourad, Algiers, 16001, Algeria



&Corresponding author
Islam Bechakh, Department of Ophthalmology, Central Hôpital of the Army, Boite Postale 244, Kouba, 16063, Algeria



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Morning glory syndrome is a rare condition defined as congenital anomaly. It was first described by Reis in 1908, but it was named by Kindler due to its resemblance to the morning glory flower. We here report the case of a 7-year-old boy presenting with alternating convergent strabismus. The patient had no family history. Ophthalmologic examination showed visual acuity 9/10 in the right eye and 5/10 in the left eye, without correction. The anterior segment and tone were normal in both eyes. Fundus examination in the right eye was normal, while in the left eye it revealed large papillary excavation, partially occupied by glial tissue, which partially masked the retinal vessels spreading radially over its entire circumference;some of them were uninhabited, evoking congenital malformation of the optic nerve head. Computed tomograpghy (CT) scan revealed left papillary coloboma, thus eliminating any morphological anomaly of the pathway of the optic nerve in its intra-orbital, intracanal and encephalic portions. Chiasma was normal. No cranio-encephalic malformation was found elsewhere. Refraction was performed as well as rehabilitation of functional amblyopia without favorable results due to delayed diagnosis. However, regular monitoring was essential to reduce the risk of retinal detachment.



Figure 1: fundus image of the left eye revealing a large papillary excavation partially occupied by glial tissue, partially masking the retinal vessels which spread radially over its entire circumference; some are uninhabited suggesting a congenital malformation of the head optic nerve