Topiramate induced sudden loss of vision

The case of a 20 year old female presenting with overnight acute loss of vision is reported. The patient was recently started on topiramate (Hitop) for her recurrent migraine and developed sudden loss of vision due to acute myopia. Topiramate was discontinued and the patient's vision returned to normal. Delayed and incorrect treatment may result in permanent vision loss, secondary to angle closure glaucoma; therefore it is imperative that prescribing physicians are aware of this rare but serious ocular emergency.