Topiramate induced acute transient myopia: a case report

INTRODUCTION: Topiramate is a sulfamate-substituted monosaccharide mainly used to treat epilepsy in children and adults and for prophylaxis of migraine. This article describes a case of topiramate induced acute transient myopia. The underlying mechanism and management is discussed. CASE PRESENTATION: A 34-year-old female complained of sudden onset of blurred vision, 9 days prior to this she had commenced topiramate therapy for migraine prophylaxis. Visual acuity was reduced to 6/36 right eye and 2/60 left eye. Examination revealed ocular anatomical and myopic refractive changes which resolved quickly following discontinuation of the drug. CONCLUSION: Ophthalmologists need to be aware of the potential ocular side effects of topiramate. Although relatively rare prompt recognition is key so appropriate management can be instituted.