Unveiling a rare aetiology of secondary acquired nasolacrimal duct obstruction: A case of morning glory syndrome with contralateral naso-ethmoidal encephalocele

Morning Glory Syndrome (MGS) is a well-established association of basal encephalocele and usually presents with midline cranio-facial anomalies. 45-year-old female presented with Secondary Acquired Nasolacrimal Duct Obstruction (SANDO) in left eye. She had a broad nasal bridge, hypertelorism and a swelling inferomedial to medial canthus. Fundus examination in right eye showed Morning Glory disc anomaly. CT of the orbit and brain disclosed left naso-ethmoidal encephalocele. CT Dacryocystography showed partial dehiscence of nasolacrimal duct bilaterally. The patient underwent surgical repair of encephalocele followed by resolution of epiphora. The association of MGS with contralateral naso-ethmoidal encephalocele and SANDO is presented for its rarity.