A case series of topiramate-induced angle closure crisis - an ophthalmic emergency

Cephalalgia. 2020 Oct;40(12):1389-1393. doi: 10.1177/0333102420946736. Epub 2020 Aug 3.

Abstract

Background: Topiramate is a drug commonly used by physicians. However, it has various systemic and ocular adverse effects. Bilateral angle closure crisis is a potentially blinding adverse reaction that is seldom reported in non-ophthalmic journals.

Objective: This article aims to report a case series of topiramate-induced angle closure crisis in the eyes.

Methods and material: Most patients presented to us with blurred vision and high intra-ocular pressure within days of starting topiramate tablet for headache. However, the attack resolved in those who presented early with prompt treatment, which included stopping topiramate.

Conclusions: Physicians prescribing topiramate must be well aware of this potentially blinding adverse effect. Educating the patient about this possible side effect is important. Timely referral and treatment can prevent blindness in these individuals.

Keywords: Topiramate; acute attack; angle closure glaucoma; ocular adverse effect.

MeSH terms

  • Adult
  • Analgesics / adverse effects*
  • Female
  • Glaucoma, Angle-Closure / chemically induced*
  • Headache / drug therapy*
  • Humans
  • Middle Aged
  • Topiramate / adverse effects*

Substances

  • Analgesics
  • Topiramate