A Curious Case of Sudden Refractive Change from Emmetropia to Myopia in a Post-LASIK Patient

The article discusses the potential ocular adverse effects of topiramate, an antiepileptic medication commonly used for migraine prevention. Topiramate-induced acute angle closure (TiAAC) is of particular concern as it can result in the sudden diminution of vision. The exact mechanism behind TiAAC i...

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Main Authors: Priyanka Gupta, Supreet Rai, Harleen Kaur, Aman Goyal
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-07-01
Series:Delhi Journal of Ophthalmology
Subjects:
Online Access:https://journals.lww.com/10.4103/DLJO.DLJO_114_23
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author Priyanka Gupta
Supreet Rai
Harleen Kaur
Aman Goyal
author_facet Priyanka Gupta
Supreet Rai
Harleen Kaur
Aman Goyal
author_sort Priyanka Gupta
collection DOAJ
description The article discusses the potential ocular adverse effects of topiramate, an antiepileptic medication commonly used for migraine prevention. Topiramate-induced acute angle closure (TiAAC) is of particular concern as it can result in the sudden diminution of vision. The exact mechanism behind TiAAC is uncertain, but it is thought to involve prostaglandin release, leading to ciliary body effusion. In this case, a young male who had been emmetropic postmyopic LASIK surgery presented to us with sudden onset high myopia. Detailed history revealed that the patient had been recently using topiramate. On examination, there was anterior displacement of iris lens diaphragm. In-depth investigations confirmed it to be a case of TiAAC. The patient was advised to discontinue topiramate and was put on topical steroids, intraocular pressure-lowering agents, and cycloplegics which relieved his condition within 10 days.
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publishDate 2023-07-01
publisher Wolters Kluwer Medknow Publications
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spelling doaj-art-c8f6bc4f9a8840e784de64c68c7f6b622025-08-20T03:11:07ZengWolters Kluwer Medknow PublicationsDelhi Journal of Ophthalmology0972-02002454-27842023-07-0133322322410.4103/DLJO.DLJO_114_23A Curious Case of Sudden Refractive Change from Emmetropia to Myopia in a Post-LASIK PatientPriyanka GuptaSupreet RaiHarleen KaurAman GoyalThe article discusses the potential ocular adverse effects of topiramate, an antiepileptic medication commonly used for migraine prevention. Topiramate-induced acute angle closure (TiAAC) is of particular concern as it can result in the sudden diminution of vision. The exact mechanism behind TiAAC is uncertain, but it is thought to involve prostaglandin release, leading to ciliary body effusion. In this case, a young male who had been emmetropic postmyopic LASIK surgery presented to us with sudden onset high myopia. Detailed history revealed that the patient had been recently using topiramate. On examination, there was anterior displacement of iris lens diaphragm. In-depth investigations confirmed it to be a case of TiAAC. The patient was advised to discontinue topiramate and was put on topical steroids, intraocular pressure-lowering agents, and cycloplegics which relieved his condition within 10 days.https://journals.lww.com/10.4103/DLJO.DLJO_114_23myopiasecondary angle closure glaucomatopiramate
spellingShingle Priyanka Gupta
Supreet Rai
Harleen Kaur
Aman Goyal
A Curious Case of Sudden Refractive Change from Emmetropia to Myopia in a Post-LASIK Patient
Delhi Journal of Ophthalmology
myopia
secondary angle closure glaucoma
topiramate
title A Curious Case of Sudden Refractive Change from Emmetropia to Myopia in a Post-LASIK Patient
title_full A Curious Case of Sudden Refractive Change from Emmetropia to Myopia in a Post-LASIK Patient
title_fullStr A Curious Case of Sudden Refractive Change from Emmetropia to Myopia in a Post-LASIK Patient
title_full_unstemmed A Curious Case of Sudden Refractive Change from Emmetropia to Myopia in a Post-LASIK Patient
title_short A Curious Case of Sudden Refractive Change from Emmetropia to Myopia in a Post-LASIK Patient
title_sort curious case of sudden refractive change from emmetropia to myopia in a post lasik patient
topic myopia
secondary angle closure glaucoma
topiramate
url https://journals.lww.com/10.4103/DLJO.DLJO_114_23
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