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Topiramate Induced Bilateral Myopia: A Potential Precursor to Acute Angle Closure Glaucoma
1Christiana Care Christiana Hospital, Newark, Delaware.
The Journal of Emergency Medicine
|June 20, 2025
Summary
Topiramate can cause acute angle closure glaucoma, a vision-threatening emergency. Emergency physicians should suspect this condition in patients with painless, bilateral vision changes, not just unilateral pain.
Area of Science:
- Ophthalmology
- Emergency Medicine
- Pharmacology
Background:
- Acute angle closure glaucoma (AACG) is a critical emergency requiring prompt recognition by emergency clinicians.
- Primary AACG typically presents with unilateral eye pain, vision changes, and elevated intraocular pressure.
- Secondary AACG can arise from various factors, including medications.
Purpose of the Study:
- To highlight a case of secondary AACG induced by topiramate.
- To educate emergency physicians on recognizing atypical presentations of AACG.
Main Methods:
- A case report detailing a patient experiencing acute myopia due to topiramate.
- Ophthalmological evaluation revealing bilateral narrowed angles despite normal initial examination.
- Surgical intervention to prevent glaucoma progression.
Main Results:
- Topiramate use led to acute-onset myopia and bilateral narrowed angles.
- The patient's condition was managed surgically to avert AACG.
Conclusions:
- Secondary AACG due to medications like topiramate can present atypically with painless, bilateral vision changes.
- Emergency physicians need high clinical suspicion for medication-induced AACG to prevent vision loss.
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