A 55-year-old male presented in emergency with sudden onset of bilateral blurred vision and headache. His visual acuity was 20/400 OD and 20/300 OS. Slit-lamp examination revealed bilateral corneal edema, shallow anterior chamber, forward displacement of lens-iris diaphragm, fixed dilated pupils. Intraocular pressures were 68 mm Hg OU. Keeping in mind bilateral presentation of acute angle closure glaucoma, we asked detailed history of patient which revealed treatment of deaddiction in the form of Topiramate drug which he had started 9 days back. So, diagnosis of topiramate induced bilateral angle closure glaucoma was made with underlying mechanism of uveal effusion syndrome. He was advised to discontinue topiramate and was administered maximum antiglaucoma medication, and cycloplegic drops. On second day, IOP returned to 29mmHg OD and 31mmHg OS. Corneal edema had decreased and AC had improved. The present case highlights unusual presentation of acute attack of ACG associated with Topiramate.
