Dr.GOURA CHATTANNAVAR
40years / female presented with bilateral sudden onset, painful loss of vision. H/o RTA 6 months ago, sustained intracranial hemorrhage. Vision in both eyes was PL & PR inaccurate & bilateral circumcorneal congestion with diffuse stromal edema & DM folds noted, AC showed grade 4 reaction. IOP was 2 & 3 mm Hg in right & left eye respectively. B-scan showed choroidals & UBM showed peripheral choroidal effusion & anterior displacement of lens iris diaphragm. On probing, patient revealed she is on amitryptylline, with recent addition of topiramate for headache by neurophysician. Diagnosis of topiramate induced uveitis was made. Patient was treated with systemic, topical steroids, topical cycloplegics and topiramte was stopped. Over a month patient vision improved with reduction in AC reaction. Careful detailed drug history & high index of suspicion for a rare idiosyncratic reaction of topiramate should be considered & made aware among the neuro-physicians.
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