DR.ARUT PRIYA

DR. SATHYAN PARTHASARATHY

Abstract

Topiramate is an anticonvulsant used as a prophylaxis against migraine. It causes secondary angle closure by ciliochoroidal effusion that result in anterior rotation of ciliary body and forward displacement of lens iris diaphragm. Here secondary angle closure seen in a patient of PACS post PI, where patient presented with sudden decrease in vision LE>RE, o/e vision RE 6/12 LE 5/60 BE showed congestion, shallow AC, patent PI, with LE Blood clots in AC and disc edema and central serous retinopathy. on history patient was taking tablet topiramate. After discontinuation of medication started on topical steroids and anti glaucoma medication. Patient recovered well with reduction in disc edema and CSR in LE, prognosis of topiramate induced angle closure is generally good, needs prompt diagnosis and appropriate treatment