Topamax is a sulfa based medication used to prevent seizures and to treat migraine headaches. Topamax can cause severe eye symptoms in pediatric and adult patients. According to an article in "Review of Optometry," patients may suffer an allergic reaction to sulfa that causes swelling and fluid accumulation in the structures of the eye, such as the lens, as well as the ciliary body, which is the part of the eye that manufactures aqueous fluid.
Acute Myopia
Myopia means nearsightedness. A person with myopia can see things that are close, but has trouble seeing things that are far away. Acute myopia in patients taking Topamax is a sudden loss of distance vision, possibly related to thickening of the lens in the eye. This may be caused by fluid accumulation in the lens, according to an article published in "Archives of Ophthalmology." Myopia usually resolves after the drug is stopped, according to Patrick Watts, author of "Review of the Ocular Side Effects of Topamax."
Angle Closure Glaucoma
Glaucoma, which is high intraocular pressure that results in damage to the optic nerve of the eye, is classified as either normal angle or narrow, or closed angle glaucoma. Closed angle glaucoma is caused by a narrowing of the angle between the Iris in the cornea. The trabecular meshwork is found at this angle, and is the site of fluid drainage from the eye. The fluid in the eye must be kept in balance, or pressure in the eye will rise; narrowing of the angle prevents fluid from reaching the trabecular meshwork. Swelling of the ciliary body, which is next to the iris, causes the angle narrowing, according to Joseph Sowka, O.D., and Alan Kabat, O.D., in "Review of Optemetry."
Angle closure glaucoma causes pain, blurred vision and reddening of the eye. Angle closure glaucoma usually occurs early in therapy, within the first month or even after the first dose, according to Sowka and Kabat. Anti-glaucoma medications should be used to lower the intraocular pressure. Vision usually returns to normal if treatment is started promptly.
Other Vision Effects
Diplopia, double vision, and nystagmus, a condition that causes the eyeball to involuntarily move rapidly from side to side, occur in approximately 15 percent of patients taking Topamax, according to Watts.
