This rare syndrome causes an abnormality in the optic nerve that resembles the morning glory flower. It usually occurs in early childhood, resulting in reduced vision, and may occur with other eye conditions, such as a lazy eye or a squint.

A collage with an image of a girl having an eye test and the morning glory flower, a name for an eye syndromeShare on Pinterest
Design by Medical News Today; photography by AzmanL/Getty Images and Lisa J. Goodman/Getty Images

Kindler first described morning glory syndrome in 1970. It is a rare condition, and the researcher reported 10 cases of the congenital syndrome in his study.

This article looks at what morning glory syndrome is, its symptoms, complications, causes, and risk factors. We also look at how doctors diagnose and treat the syndrome and its similarities to other eye syndromes.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

Morning glory syndrome causes an enlarged, funnel-shaped cavity of the optic disc, where the optic nerve fibers leave the retina.

The syndrome occurs when the optic nerve does not fully form during fetal development. An increased number of blood vessels curve from the enlarged disc, giving it an appearance similar to flower petals.

Occurrence

On average, this syndrome develops at age 9. The prevalence of morning glory syndrome is 2.6 per 100,000 people.

Most reported cases — 85% — are unilateral, affecting one eye, while 15% are bilateral, affecting both eyes. The condition affects both males and females.

Symptoms of morning glory syndrome include poor vision in the affected eye and poor visual acuity — the ability to see the sharpness or clarity of an object from a certain distance.

Visual acuity can vary from 20/20 vision (good vision) to very poor vision, depending on the extent of the nerve defect. Visual acuity ranges from 20/200 to no light perception.

People may also have:

  • visual field defects
  • enlarged blind spots
  • an improperly shaped cornea or lens, or astigmatism
  • nearsightedness, or myopia
  • esotropia in the affected eye, meaning that the eye turns inward, or exotropia, meaning that it turns outward

Additionally, a person may experience leukocoria, a white discoloration of the pupil that may develop in the first few months or years of life.

Morning glory syndrome may occur by itself or along with other eye conditions, such as:

  • crossed eyes, or strabismus, which may occur in 80% of cases
  • lazy eye, or amblyopia, which may contribute to poor vision in unilateral cases
  • non-ocular conditions, such as brain disorders

Typically, individuals with non-ocular issues may also have the following:

  • an enlarged head
  • a depressed nasal bridge
  • a mid-upper lip defect or cleft

Signs

Balance issues are another possible sign of morning glory syndrome. Additionally, a child may tilt their head toward the good eye.

Complications

If a person does not receive a prompt diagnosis, this condition can lead to potentially serious complications.

The most severe complication is retinal detachment, which can occur in 26–38% of people with morning glory syndrome.

Other complications that can impair vision include retinoschisis, in which the layer of the retina splits in two, and neovascularization, the formation of new blood vessels in the subretinal space.

Experts do not fully understand the causes or risk factors of morning glory syndrome.

Family history is usually not present, though evidence suggests that cases of cavitary optic disc anomalies are inherited diseases.

Some research also suggests that a mutation in the PAX6 gene may cause the eye defect. Researchers are undertaking more investigations to determine the cause.

Eye doctors usually diagnose morning glory syndrome in children by age 2. However, in some cases, a child may receive a diagnosis later, at up to age 5.

Doctors typically diagnose morning glory syndrome with the following tests:

  • physical and ophthalmological examination
  • evaluation of the medical history
  • imaging scans to rule our central nervous system involvement
  • a fundus examination, in which a doctor checks the inside of the eye through a dilated pupil by using an ophthalmoscope, which helps detect retinal detachments

Clinical diagnosis

During the fundus examination, a doctor may observe the following signs:

  • a funnel-shaped optic disc and its surrounding area
  • an enlarged disc with an unclear border
  • abnormally narrow, straight blood vessels that radiate from the outer edge of the disc

Currently, there is no treatment for morning glory syndrome. The available treatment aims to prevent and treat the complications that may arise. For example, doctors can treat retinal detachment with vitreoretinal surgery, where necessary.

Eye doctors try to optimize people’s visual acuity to prevent amblyopia.

It may also be helpful for a child to wear an eye patch over the better eye to help improve vision in the affected eye.

Research continues to investigate the most effective treatment for this rare syndrome.

Management

Doctors will closely monitor a child during the initial period after diagnosis and treat any complications. After this period, the condition becomes more stable in most cases.

Generally, children with morning glory syndrome can lead typical lives, even with squints and lazy eyes. However, they will need to wear glasses to perform daily activities into adulthood.

Doctors may mistake morning glory syndrome for optic nerve coloboma or peripapillary staphyloma. Both conditions have similar characteristics to the morning glory disc anomaly.

These conditions and other eye abnormalities may have overlapping symptoms, so healthcare professionals will conduct additional tests to provide an accurate diagnosis.

Morning glory syndrome is a rare congenital eye anomaly. The researcher who first described the condition likened the appearance of the anomaly to the morning glory flower.

The syndrome usually affects one eye. However, in rare cases, it may occur in both eyes. The main symptoms are lazy eyes, poor vision, color perception difficulties, and squinting. Some people with the condition may have a risk of retinal detachment. Doctors will monitor a person’s condition and address any complications that may arise.

To avoid serious complications, people should receive a prompt diagnosis. Doctors usually diagnose the syndrome through imaging scans and examinations to check inside the eye.

Currently, there is no treatment for morning glory syndrome. Instead, treatment aims to prevent and treat the complications.