Topiramate-Induced Bilateral Acute Angle-Closure Glaucoma in an Adolescent with Migraine: A Case Report

Open Access

Abstract

Topiramate is a sulfamate-substituted monosaccharide commonly used for epilepsy and migraine prophylaxis. Although generally well tolerated, it may rarely precipitate bilateral acute angle-closure glaucoma (AACG), a potentially vision-threatening ophthalmic emergency. I report a 16-year-old girl who developed bilateral painful visual loss within 48 hours of initiation of low-dose topiramate 25 mg daily for migraine prophylaxis. Prompt recognition, discontinuation of the offending drug, and early ophthalmologic management resulted in complete visual recovery within one week. This case highlights the importance of early recognition of topiramate-induced angle closure, particularly in adolescents receiving low doses of the drug.