Bilateral acute onset myopia and angle closure glaucoma after oral topiramate: a case

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Bilateral acute onset myopia and angle closure glaucoma after oral topiramate: a case report. J Med Assoc Thai. 2008 Dec;91(12):1904-7 Authors: Boonyaleephan S OBJECTIVE: Describe bilateral acute onset myopia and angle-closure glaucoma as ocular adverse effects of topiramate. CASE REPORT: A 23 year-old woman developed bilateral severe blurred vision seven days after initiating therapy with topiramate. Her visual acuity was counting fingers in both eyes. Intraocular pressures were 33 mmHg and 32 mmHg in the right and left eyes, respectively, with conjunctival chemosis, corneal edema, shallow anterior chambers, and closed angles. Her refraction was -7.50 diopters in both eyes. The symptoms and clinical findings resolved completely upon discontinuation of topiramate and, administration of antiglaucoma drugs. CONCLUSION: Topiramate use can result in acute bilateral angle-closure glaucoma and myopia, which are usually reversible upon cessation of the drug. Visual outcome is usually good and the episode resolves within a few weeks. Thus, it is important for clinicians to recognize these conditions and educate patients about these serious adverse effects when prescribing topiramate. PMID: 19133528 [PubMed - indexed for MEDLINE]

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[Arun Kaistha]

brand name TOPAMAX: common!

I've already seen two very similar cases of younger female patients on Topamax, which is a fairly commonly prescribed drug. I know this problem is being extremely under-reported, but I'm certain it will be a well-known problem with Topamax soon enough.

Ask your colleagues, I bet someone you know has also seen a case or even two of this...d/c'ing he med would do although before I knew that, the MD I worked with was called in for a probably unnecessary PI OU, didn't hurt but I'm now sure it would've been fine on just anti-glc meds and d/c of Topamax.