What are the other Names for this Condition? (Also known as/Synonyms)

• Congenital Optic Disc Dysplasia
• MGS (Morning Glory Syndrome)
• Morning Glory Optic Disc Anomaly 

What is Morning Glory Syndrome? (Definition/Background Information)

• Morning Glory Syndrome (MGS) is a rare birth defect. In this condition, the optic disc (part of the eye, from where the optic nerve leaves to the brain) is abnormal. Medically, this abnormality is called Congenital Optic Disc Dysplasia
• The term “morning glory” conveys a similarity of the optical disc, to the flower of the morning glory plant. This finding is observed, when an eye doctor examines the back of the eye using an instrument, called an ophthalmoscope. The picture of the optical disc resembles the center of a morning glory flower
• Morning Glory Syndrome is a very rare syndrome with an estimated incidence of 1 in 10 million, in the global population. Generally, one eye is affected; however, in rare cases, both eyes may be affected causing significant signs and symptoms
• Some individuals have mild symptoms, while others may have more severe symptoms. The main symptoms of MGS include lazy eye, poor vision, color perception difficulties, and squinting. There is also a risk of retinal detachment in individuals, as the condition progresses
• The cause of MGS and its risk factors are unknown. There is also no cure for this eye disorder
• The treatment focusses mainly on decreasing the burden of reduced vision, using various interventions
• The prognosis of Morning Glory Syndrome depends upon the severity of the symptoms; which varies from one case to another 

Who gets Morning Glory Syndrome? (Age and Sex Distribution)

• Morning Glory Syndrome is a very rare, non-hereditary disorder affecting the eye. This means that the condition is not transmitted in families, from one generation to the next generation
• The condition is usually diagnosed in children
• Females are more likely to be affected than males; a ratio of 2:1 female-male incidence is noted 

What are the Risk Factors for Morning Glory Syndrome? (Predisposing Factors)

There is very little information available on the cause of Morning Glory Syndrome. Hence, no known risk factors exist that predispose an individual to developing MGS. 

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider. 

What are the Causes of Morning Glory Syndrome? (Etiology)

• The cause of Morning Glory Syndrome developmental defect is unknown
• A developmental defect is a birth defect that affects the baby in the mother’s womb, during pregnancy. The exact reason why these defects occur in some babies is unknown
• Some studies have shown a mutation in PAX6 gene, to be the probable cause of Morning Glory Optic Disc Anomaly. Research is being performed to arrive at a definitive cause of this condition 

What are the Signs and Symptoms of Morning Glory Syndrome?

Typically, only one eye is affected in Morning Glory Syndrome. But, in some rare cases, both eyes may be affected, causing significant signs and symptoms. The signs and symptoms of this eye disorder are usually detected in a child, after the first 12 months of the child's life. The signs and symptoms of Morning Glory Syndrome are outlined below. 

Symptoms:

• Poor vision
• Lazy eye (amblyopia)
• Color perception difficulties
• Squinting of the eye (strabismus) - eye that drifts severely away from the child's fixed point of reference
• Other neurological symptoms, depending on associated congenital conditions
• Feeding difficulties, if associated with cleft palate 

Signs:

• The first noticeable signs of this syndrome, usually appear in the first year of life
• Whitish discoloration of the pupil (leukokoria) may develop in the first few months to years of life
• The child may develop issues of balance, as he/she learns to sit or walk
• Often, it may be noticed that the child leans or tilts their head toward the good eye, to correct the brain's skewed vision (of the perception of the world around them). The child may often fall in the same direction while walking, or may bump into objects placed on his/her blind side
• The child may have refraction symptoms, such as near vison (myopia), astigmatism, and far vision (hypermetropia)
• On the ophthalmoscopical examination of the fundus (an eye doctor checks the inside of the eye globe, through dilated pupil) with a special type of instrument, known as an ophthalmoscope, the following signs may be observed:
  • Funnel-shaped, excavation of the optic disc and its surrounding area.
  • Enlarged disc with indistinct border, surrounded by thinned-out areas
  • White, elevated, hyperplastic glial tissues, occupying the central disc
  • Abnormally narrow, straight vessels, radiated from the disc margins
  • The appearance simulates the center of a morning glory flower

How is Morning Glory Syndrome Diagnosed?

Morning Glory Syndrome is usually diagnosed after the following exams and tests are performed:

• Complete physical and ophthalmological examination
• Thorough evaluation of medical history
• Fundus examination - which is carried out by an eye doctor with a special instrument, called an ophthalmoscope, to see the inside of the eye through dilated pupil
• Radiological studies, such CT scans, cranial MRI/MR angiography and MRI scans, if there are other associated congenital defects 

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. 

What are the possible Complications of Morning Glory Syndrome?

Complications of Morning Glory Syndrome may include:

• An increased risk of retinal detachment has been seen in individuals with Morning Glory Syndrome. Retinal detachment causes the separation of the photosensitive layer of the eye, called retina, from the back layers of the eyeball. Retinal detachment is a surgical emergency, which can cause blindness, if it is not treated immediately
• Some children may have other birth defects. Studies have shown that this condition may be associated with developmental birth defects, involving the brain and spinal cord. Such conditions may include:
  • Basal transsphenoidal encephalocele
  • Agenesis of corpus callosum
  • Defect of the floor of the sella turcica
  • Chiasma agenesis
• Rarely, Morning Glory Syndrome may be associated with widely placed eyes (hypertelorism) or cleft palate
• Social and cultural ostracism, social isolation, may cause significant burden in the individual’s life 

How is Morning Glory Syndrome Treated?

Currently, there is no cure for Morning Glory Syndrome. The treatment is symptomatic and is also directed towards preventing and treating the complications, which may arise.

• A limited trial of eye patching of the better eye in affected children (less than 9 years old) can improve vision in the affected eye
• About 30% of the individuals with MGS are observed to develop retinal detachment. However, this can be treated successfully with modern vitreo-retinal surgery
• Social and psychological support can help reduce the stress on individuals and help them cope with daily life, study, and work 

How can Morning Glory Syndrome be Prevented?

• Morning Glory Syndrome is a congenital birth defect. The cause of the condition is unknown and currently, there are no methods to prevent this eye disorder
• Active research is being performed to explore the possibilities for the treatment and prevention of MGS 

What is the Prognosis of Morning Glory Syndrome? (Outcomes/Resolutions)

• The prognosis for individuals with Morning Glory Syndrome varies greatly; it depends on the types and severity of symptoms present in the individual
• With mild symptoms, most individuals can lead relatively normal lives, without too many difficulties. As the severity of symptoms increases, it becomes more and more difficult to lead a normal life
• The initial period of infancy requires close monitoring of the situation and of any complications that may arise (which have to be averted). Once this period passes, in most individuals, the disorder is seen to progress to a more stable condition
• Children with Morning Glory Syndrome lead normal lives; even in the case of children, who have squint and lazy eyes. Adult individuals are also able to drive vehicles. However, safety glasses have to be worn for the remainder of one’s life, especially while participating in certain sports activities
• Activities that require keen 3-dimensional vision with depth perception, like gymnastics and ice-skating, are more difficult to pursue for individuals with Morning Glory Syndrome; though, such activities are still possible with adequate treatment and supportive care 

Additional and Relevant Useful Information for Morning Glory Syndrome:

• Optic disc coloboma is often confused as Morning Glory Syndrome; optic disc coloboma (an infrequent optic nerve disorder) is a different condition
• Rare cases of bilateral Morning Glory Syndrome may be associated with autism