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TOPIRAMATE-INDUCED BILATERAL ANGLE-CLOSURE GLAUCOMA. A CASE REPORT.
Summary
Topamax (topiramate) can cause secondary angle-closure glaucoma. Discontinuing Topamax and using specific eye drops resolved the condition in a patient experiencing vision loss.
Area of Science:
- Ophthalmology
- Pharmacology
Background:
- Topamax (topiramate) is prescribed for epilepsy and migraine management.
- A rare side effect of Topamax is secondary angle-closure glaucoma, stemming from supraciliary effusion.
- Bilateral angle-closure glaucoma should prompt consideration of drug-induced etiology.
Observation:
- A 51-year-old patient on Topamax presented with acute vertigo, headache, and blurred vision.
- Ophthalmic examination confirmed bilateral angle-closure glaucoma.
- Initial treatments included antiglaucoma drugs, pilocarpine, osmotic agents, and laser iridotomy without full resolution.
Findings:
- Standard glaucoma treatments were ineffective.
- Discontinuation of Topamax was crucial for recovery.
- The addition of topical cycloplegics and corticosteroids successfully relieved the angle closure and normalized intraocular pressure.
Implications:
- Physicians must recognize Topamax as a potential cause of secondary angle-closure glaucoma.
- Prompt identification and discontinuation of the offending drug are vital for effective management.
- Ophthalmologists should consider drug-induced glaucoma in cases of bilateral angle-closure, especially in patients on Topamax therapy.
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