Dr.Rashmi kumari, K12746
Topiramate,an antiepileptic drug,has overwhelmingly been used in migraine recently.It has been reported to cause secondary angle closure mimicking acute congestive attacks.Bilateral presentation rises the suspicion.Here we report a case of young female presenting with sudden onset bilateral decrease of vision associated with bifrontal headache.Examination revealed raised IOP in both eyes with circumciliary congestion and extremely shallow AC.Drug history confirmed treatment for migraine with oral Propranolol and recently added Topiramate. Case was diagnosed as topiramate induced bilateral acute angle closure glaucoma and confirmed by ultrasound biomicroscopy which showed bilateral supraciliary effusion and angle closure Topiramate was promptly stopped and the patient was treated with topical/oral anti-glaucoma medicines and steroids.This resulted in complete resolution of supraciliary effusion and opening of angles.
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