Bilateral Acute Onset Myopia and Angle Closure Glaucoma after Oral Topiramate: A Case Report
Sumalee Boonyaleephan MD*
Affiliation : * Department of Ophthalmology, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok
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.
Keywords : Topiramate, acute myopia, acute angle-closure glaucoma
