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  • Title: Mechanism of topiramate-induced acute-onset myopia and angle closure glaucoma.
    Author: Craig JE, Ong TJ, Louis DL, Wells JM.
    Journal: Am J Ophthalmol; 2004 Jan; 137(1):193-5. PubMed ID: 14700673.
    Abstract:
    DESIGN: Interventional case report. METHODS: In an institutional practice setting, two women, aged 25 and 45, developed acute myopia after starting topiramate for epilepsy. One patient also developed bilateral angle closure glaucoma. RESULTS: Topiramate was discontinued. Anterior chamber shallowing was noted in both patients at presentation. Ultrasonography showed ciliochoroidal effusion. Baseline measurements of anterior chamber depth and lens thickness were obtained. CONCLUSIONS: Topiramate may be associated with ciliochoroidal effusion with forward displacement of the lens-iris diaphragm and anterior chamber shallowing, resulting in acute myopia and angle-closure glaucoma. Increased lens thickness contributes only minimally (9%-16%) to anterior chamber shallowing.
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