Purpose : To describe a case series of bilateral acute angle-closure glaucoma due to use of topiramate
therapy
Cases report: Three cases were presented with blurred vision, severe nausea and headache after
initiation of topiramate oral intake due to migraine and weight loss. Best corrected visual acuity were
markedly reduce with very high Intraocular pressure in both eyes of three cases. Bilateral conjunctival
chemosis, shallow anterior chamber and mild to moderate corneal edema were observed. Topiramate
therapy was discontinued. Topical therapy was initiated in both eyes with Prednisolone, cycloplegic
and anti glaucoma medications.
Results: Pain was reduced with improvement of visual acuity after starting of treatment. Intraocular
pressure was also reduced to normal level after 2- 7 days. No residual effects were found in any cases.
Conclusion: Topiramate therapy may be associated with myopic shift with secondary bilateral angle
closure glaucoma due to ciliochoroidal effusion. So patient must be counseled and monitored for
development of angle closure to prevent permanent loss of vision