Is Topamax associated with a myopic or hyperopic shift?

Topamax, also known as topiramate, is primarily used as an anticonvulsant and for migraine prophylaxis. A known adverse effect of Topamax is acute myopia, which can occur due to changes in the ciliary body and lens resulting in a secondary angle-closure glaucoma. The myopic shift occurs because the drug can induce a forward rotation of the ciliary body, causing a decrease in the anterior-posterior dimension of the eye.

This shift is clinically significant, as it can lead to visual changes and discomfort for patients. The acute nature of these changes means they can happen quickly after starting the medication or during dose adjustments. Understanding the pharmacological effects of Topamax on ocular conditions is crucial for managing the potential side effects associated with its use effectively. Therefore, recognizing that Topamax is associated with a myopic shift is essential for both patient safety and proper clinical practice.