What another optic nerve anomaly you might consider in this setting?
Optic nerve coloboma and Morning glory anomaly might be considered clinically. However, Morning glory syndrome is almost universally a sporadic condition whereas optic nerve coloboma is commonly familial.
Fundus photos are illustrating normal left optic nerve (B) while right optic nerve is demonstrating Morning Glory anomaly (A).
Of note are the more significant overall size, halo of pigmentary changes surrounding the nerve (yellow dashed circle), and the radial orientation of the blood vessels (black arrows) emanating from the anomalous optic nerve.