Morning Glory optic nerve in 4 year old

[arizonamom101]

My daughter was diagnosed with this back in September. She has some vision in her affected (right) eye, so we are patching the good eye (left) 2 hrs daily. Her ophthalmologist made this finding during an exam for a slight esotropia. My question is, over the last few months I notice a weakness on the same side of her face ie: when she smiles the right upper lip droops a bit as well as the cheek area. Her right eye appears slightly larger than the left and her lower lip has a small amount of sagging as well. Our pediatrician referred her to a neurologist, who said she has hypoplasia of the anguli oris muscle. is there a specific condition that relates to both of these findings. i can't help but think that the weakness is all related & worry if there is more to her situation.

[John C Hagan III, MD, FACS, FAAO]

Yes there were other abnormalities. The child was under treatment at Children's Mercy Hospital in Kansas City, a top US peds hospital. I do not recall specifically what they were.

Good luck to you.

JCH MD

[arizonamom101]

Thanks for taking the time to comment. May I ask, in the one case you saw, were there other associated abnormalities? We are just trying to put the pieces together, since this is a rare defect there isn't much information available.

[John C Hagan III, MD, FACS, FAAO]

Morning glory optic nerve occurs in about one in 2 million births so it is rare and I have only seen once case. However in reviewing several reviews it is often associated with other neurological and facial abnormalities.

Here is a good review:

http://en.wikipedia.org/wiki/Coloboma_of_optic_nerve

JCH MD