IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 17, Issue 6 Ver. 2 (June. 2018), PP 39-41 www.iosrjournals.org DOI: 10.9790/0853-1706023941 www.iosrjournals.org 39 | Page A Rare CaseOf UnilateralMorning Glory DiscWithPHPV CataractAndProminent Ciliary Processes Priti Shende 1 ,V Rajesh Prabu 2 , JK Reddy 3 1. Fellow in Department of Paediatric Ophthalmology &Strabismus,Sankara Eye Hospital,Coimbatore,TamilNadu,India 2. Consultant & Head, Department of Paediatric Ophthalmology & Strabismus, Sankara Eye Hospital,Coimbatore ,Tamil Nadu,India 3. Consultant &Head ,Department of Cornea, Sankara Eye Hospital,Coimbatore ,Tamil Nadu ,India *Corresponding Author:Priti Shende Abstract:Morning glory disc anomaly is a congenital excavation of the posterior pole that involves optic disc .It is usually unilateral and common in females (2:1) . Some authors postulates, as failure of closure of the fetal fissure and it is a variant of optic nerve coloboma. Alternatively, a primary mesenchymal abnormality has been demonstrated on the basis of the glial tuft, the scleral and vascular abnormalities .We report a case of an 11 year old girl,with diminution of vision in right eye alongwith deviation of eye inwards since childhood. Anterior segment showed prominent ciliary processes,cataractwith morning glory disc and PHPV stalk attaching from the disc. There was no systemic abnormality.Patient underwent right eye cataract surgery.Morning glory syndrome is associated with many cerebro vascular abnormalities.Systemic workup should be done. Along with persistent hyperplastic primary vitreous ,patient is at risk of developing strabismus ,amblyopia. If diagnosed early ,patients can be benefitted by surgery and restoration of vision. Keywords:Morning glory disc , MGS , Persistent hyperplastic primary vitreous, PHPV, PAX 6 --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 23-05-2018 Date of acceptance: 05-06-2018 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Morning glory syndrome is so named because of its resemblance to the morning glory flower. It was first named by killer in 1970. It is a congenital funnel shaped excavation of the posterior fundus which incorporates the optic disc, with a white tuft of glial tissue overlying the central portion of the disc and the increased number of blood vessels arising from the periphery of the disc. [1] Persistent hyperplastic primary vitreous (PHPV) occurs because of failure of the primary vitreous and the hyaloid system to regress. PHPVtypically manifests as unilateral, persistence of hyaloid system i n the cloquet’s canal. It is associated with microphthalmia ,cataract, retinal traction or dysplasia, and elongation of ciliary processes. [2,3] II. Case Report An 11 year old girl presented to our hospital with diminution of vision in right eye since childhood .Best corrected Visual acuity in Right eye was 3/60. Slit lamp biomicroscopyof the anterior segment showed posterior polar cataract and prominent ciliary processes(figure 1).Fundus examination with (+90 D and IDO) was done which showed funnel shaped excavated disc along with peripapillary staphyloma at the centre of which was a greyish white tuft of tissue with blood vesesls running from the disc to the periphery of the retina (figure 2&3).These vessels were abnormally straight , veins and arteries which could not be precisely distinguished . B -scan ultrasound showed prominent hyaloid artery attached to the disc.Extraocular movements were full and free in all gazesand14 prism dioptres of esotropia was noted on modified krismky test. Left eye anterior and posterior segments were normal. Systemic examination was insignificant .Patient underwent an uneventful cataract surgery with PCIOL implantation through anterior limbal approachin the right eye.Best corrected visual acuity of 6/60was achieved after one month. Patient is still under follow-up.