DR. DIVYA WAKODKAR

DR.VEENA C.N., DR.SWATI R, DR. RAGHAVENDER REDDY ARRA

Abstract

Two female patients in their twenties presented with sudden onset of blurred vision in both eyes. The first patient came with sudden onset myopia, bilateral angle closure and elevated intraocular pressure. The second patient had sudden onset myopia. Both were on oral topiramate 25mg once daily. Topiramate, even at low doses, is known to cause sudden onset myopia with acute angle closure due to ciliochoroidal effusion. This ocular emergency was stabilized within two days by discontinuing topiramate along with starting steroids, cycloplegics and anti-glaucoma medications. Close monitoring of the patients started on topiramate is necessary irrespective of the dosage because of the idiosyncratic response to the drug. Patients should be told of possible side-effects while starting treatment and to report to the emergency room at the earliest.