Topiramate-induced uveal effusion with myopia without angle closure: A case report

Topiramate-induced acute angle closure is a well-known entity with onset of symptoms at 2 weeks following treatment initiation. We report a 24-year-old female with blurring of vision 2 days after increasing the topiramate dose for migraine prophylaxis. Examination showed increase in manifest myopia with normal intraocular pressure and absence of angle closure. Provisional diagnosis of topiramate-induced myopia (TIM) was made, confirmed by presence of uveal effusion on B-scan and ultrasound biomicroscopy. Early presentation during the course could be the reason for isolated myopia. She was advised to stop topiramate and was started on cycloplegics. This case highlights that awareness about TIM among patients helps in prompt management, thus preventing the site-threatening acute angle closure.