DR. AGRIMA BHATIA

DR. ANJALI MAHESHWARI, DR. SANTOSH KUMAR, DR.HS TREHAN

Abstract

An interesting case of a 38-year-old male who presented with bilateral sudden onset, painful diminution of vision associated with headache and nausea. His BCVA was 6/6 with -5.50 DS both eyes. He had raised intraocular pressure of OD-60 mm Hg and OS-50 mm Hg with shallow anterior chamber OU. Patient was a driver by profession and did not give any history of use of spectacles in past. This prompted us to check his axial length, which was normal. This discrepancy made us revisit his history to justify the acute onset myopia associated with raised IOP. It was then that he divulged history of taking some drugs for intractable headache 2 weeks back, which was later established to be Topiramate. Ultrasound biomicroscopy revealed B/L ciliochoroidal effusion. Topiramate was discontinued and he was managed with oral anti glaucoma drugs. Presently his UCVA is 6/6 OU and IOP is normal without anti glaucoma drugs. This case illustrates significance of meticulous history and step wise approach.