This four-year-old female presented at age one with a left exotropia. Her vision is poor in this eye and she has a large relative afferent pupillary defect.
Her left optic disc is enlarged and the vessels are straightened and radiate outward from a central glial tuft. These are features of morning glory disc anomaly. However, the patient also has a very deep excavation of the peripapillary sclera and atrophy of the overlying retina consistent with a peripapillary staphyloma.
Morning glory disc is a non-hereditary congenital or developmental anomaly that is usually unilateral and occurs more frequently in females. Visual acuity can range between normal to no light perception, but is usually between 20/100 to 20/200. Associated problems include serous macular retinal detachments and basal enchephaloceles.
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