DR. MANOGNA AITHARAJU

DR.M S RAVINDRA, DR.KARTHIK R MEDA

Abstract

PURPOSE – To report an interesting case of unilateral acute myopia , angle closure secondary to topiramate

CASE SUMMARY – A 20 year old presented with right eye pain, blurred vision since 2 days. Refraction showed a -3.25D myopic shift with shallow anterior chamber, appositional angle closure and intraocular pressure of 27mmhg. Left eye refraction remained stable with normal anterior chamber depth, open angles and normal IOP History of use of topiramate tablet 50 mg, started 3 days back for migraine. Immediate discontinuation of the drug along with topical steroids and cycloplegics reversed the myopia, angle closure and reduced IOP

CONCLUSION – Drug induced idiosyncratic reaction can be unilateral or asymmetrical. Prompt diagnosis and discontinuation of the causative drug can prevent the other eye involvement and can rapidly reverse the changes in the involved eye.