Topiramate Induced Bilateral Acute Angle Closure Glaucoma

Abstract

Topiramate is an anti-epileptic drug commonly used for the treatment of abdominal migraine. Rare cases of acute myopia with secondary angle closure glaucoma have been reported due to topiramate therapy. An adult male was prescribed topiramate oral therapy for abdominal migraine. On the 4th day of treatment, he had blurring of vision and on ocular examination there was severe myopia, both the iridocorneal angles were closed and intraocular pressure (i.o.p) was 48mmHg. Diagnosis of drug induced bilateral acute angle closure glaucoma was made and treatment was started. Similar cases with topiramate were reported previously but it developed after 2 weeks of therapy. In our case it occurs on the 4th day of therapy. So physician should be aware of possible ocular side effects from the 1st day of therapy and to seek immediate ophthalmic investigation in the events.