Dr. RUHI GUNAY

Dr. MEHUL SHAH, Dr. SHREYA SHAH, DR. HEENA PATEL

Abstract

INTRODUCTION: Topiramate may cause acute myopia and an increase in intraocular pressure due to anterior rotation of ciliary body leading to a shift of lens-iris diaphragm.

METHOD: Presenting a case of a 26 year old female with c/o sudden, painful diminution of vision since 2 days. History revealed that the patient was taking Topiramate, an anti convulsant medication. Iop of 37.2 mm hg was recorded in both eyes alongwith a refractive error of -5.0sph. Posterior segment was within normal limits. She was started on anti glaucoma medications. Pod 3, IOP reduced to normal limit, refractive error remained unresolved. The patient was advised to discontinue topiramate and take an alternative anti convulsant drug. Pod 6, the vision improved drastically, IOP was within normal limits and the myopic shift was reversed.

CONCLUSION: Idiosyncratic adverse effects of drugs can present with Secondary Glaucoma ,therefore one should keep in mind the uncommon side effects of commonly used drugs.