title: Bilateral acute angle-closure glaucoma following treatment with topiramate for headache.
abstract: BACKGROUND
  This case report adds supportive evidence to the development of acute angle-closure glaucoma (AACG), a rare but serious adverse effect following the use of topiramate (TPM) for a severe headache.
  
  
  METHODS
  A 25-year-old female reported with severe headache, suspected to be migraine, and was started on TPM 25 mg/day on the first day. However, she presented at the emergency clinic of a hospital with sudden blurring of vision and colored halos 5 days after stopping the drug, i.e., day 8. She was subjected to ophthalmic examination and was diagnosed with AACG. The intraocular pressure (IOP) was found to be elevated and she was hence started on acetazolamide 500 mg instantly, maintained on tablet acetazolamide 250 mg four times a day (QID), pilocarpine 2% eye drops QID, travoprost 0.004% once a day (OD), and dorzolamide 2% eye drops three times a day (TID). After a week's treatment, there was rapid improvement with return of IOP to normal.
  
  
  CONCLUSIONS
  TPM-induced AACG is a rare serious adverse event leading to blindness but is preventable, when diagnosed early and by instituting appropriate treatment.
authors.affiliation: Division of Clinical Pharmacology, St. John's Medical College, Bangalore, India.
authors.forename: Chanda
authors.initials: C
authors.lastname: Kulkarni
authors.affiliation: Dayananda Sagar College of Dental Sciences, Kumaraswamy Layout, Bangalore, Karnataka India ; University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX USA.
authors.forename: Urmimala Ray
authors.initials: UR
authors.lastname: Chaudhuri
authors.affiliation: Division of Clinical Pharmacology, St. John's Medical College, Bangalore, India.
authors.forename: Annalakshmi
authors.initials: A
authors.lastname: Jagathesan
keywords: Acute angle-closure glaucoma; Headache; Intraocular pressure; Neurology; Ophthalmology; Topiramate