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Related Experiment Video

Updated: May 11, 2026

Full-Circle Cauterization of Limbal Vascular Plexus for Surgically Induced Glaucoma in Rodents

Full-Circle Cauterization of Limbal Vascular Plexus for Surgically Induced Glaucoma in Rodents

Published on: February 15, 2022

Delayed topiramate-induced bilateral angle-closure glaucoma.

Craig N Czyz¹, Cooper M Clark, Joshua D Justice

¹*Division of Ophthalmology †Section Oculofacial Plastic and Reconstructive Surgery, Ohio University/Ohio Health Doctor's Hospital §Department of Ophthalmology, Division of Glaucoma, Ohio State University Havener Eye Institute, Columbus, OH ‡Department of Ophthalmology, Carle Urbana, Urbana, IL.

Journal of Glaucoma

|May 2, 2013

Summary

This case report details a delayed reaction to topiramate, where a patient developed bilateral angle closure glaucoma after 262 days of consistent use. Prompt discontinuation of the medication resolved the acute attack.

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Last Updated: May 11, 2026

Full-Circle Cauterization of Limbal Vascular Plexus for Surgically Induced Glaucoma in Rodents

Full-Circle Cauterization of Limbal Vascular Plexus for Surgically Induced Glaucoma in Rodents

Published on: February 15, 2022

Area of Science:

Ophthalmology
Pharmacology
Neurology

Background:

Topiramate is an anticonvulsant and migraine prophylactic medication.
Angle-closure glaucoma is a condition characterized by sudden blockage of the drainage angle in the eye.
Ocular side effects of topiramate, including angle closure, are typically acute and idiosyncratic.

Observation:

A 40-year-old woman presented with symptoms of bilateral acute angle-closure glaucoma.
The patient had been on a stable dose of topiramate for 262 days prior to symptom onset.
Initial examination revealed severely elevated intraocular pressures and closed anterior chamber angles.

Findings:

Discontinuation of topiramate and medical management successfully resolved the acute angle-closure glaucoma attack.
At 3-month follow-up, the patient's visual acuity improved to 20/25, with open angles and normalized intraocular pressures.
This case highlights a delayed onset of topiramate-induced bilateral angle closure.

Implications:

This case suggests that topiramate can induce angle closure with a delayed presentation, challenging the notion of solely acute idiosyncratic reactions.
Further research into the cellular mechanisms underlying both immediate and delayed topiramate-induced angle closure is warranted.
Clinicians should maintain a high index of suspicion for delayed ocular side effects of topiramate, even after prolonged stable use.