The antiseizure drug topiramate (Topamax) has been associated with an ocular syndrome characterized by acute myopia and secondary angle-closure glaucoma.47-53 This syndrome is associated with supraciliary effusion resulting in anterior displacement of the lens and iris, with secondary angle-closure glaucoma. Symptoms typically occur within a month of initiating therapy. Secondary angle-closure glaucoma associated with topiramate has been reported in pediatric patients as well as adults. Blurred vision is frequently the first presenting symptom. The primary treatment to reverse symptoms is discontinuation of topiramate.53 Peripheral iridectomy is generally ineffective for this syndrome.
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