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Topiramate induced myopic shift and angle closure glaucoma
  1. T C Chen1,
  2. C W Chao2,
  3. J A Sorkin3
  1. 1Harvard Medical School, Massachusetts Eye and Ear Infirmary, Glaucoma Service, 243 Charles Street, Boston, MA 02114, USA
  2. 2Harvard Medical School, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, 243 Charles Street, Boston, MA 02114, USA
  3. 3Childrens Hospital, Department of Ophthalmology, Microsurgical Consultants, 31 Centennial Drive, Peabody, MA 01960, UK
  1. Correspondence to: Teresa C Chen, MD, Massachusetts Eye and Ear Infirmary, Glaucoma Service, 243 Charles Street, Boston, MA 02114, USA; teresa_chen{at}meei.harvard.edu

https://doi.org/10.1136/bjo.87.5.648

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    Topiramate (Topamax; Ortho-McNeil Pharmaceutical, Raritan, NJ, USA) is an oral sulfamate medication used primarily for seizure treatment. We report two cases of topiramate induced uveal effusions. In one case, prompt discontinuation of topiramate prevented bilateral angle closure glaucoma. To our knowledge, case 1 is the first case in the ophthalmic literature describing myopic shift without glaucoma.

    Case 1

    A 42 year old woman presented with a complaint of 1 day of blurry vision. Her medical history was notable for hypertension and seizures. She had never worn glasses. Medications included hydrochlorthiazide, Depakote, and Flovent. Topamax was started 2.5 weeks before examination which revealed 20/200 in both eyes without correction (20/20 both eyes with −4.00–0.75 × 76 right eye −4.00–1.00 × 90 left eye). Pupils and pressures were normal. Anterior chambers were shallow, and gonioscopy revealed angles open to posterior trabecular meshwork in both …

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