Topiramate-induced hypertensive uveitis and evolving Fuchs′ uveitis: A case report

Abstract

We intend to report an interesting case of topiramate-induced bilateral uveitis (TIU) and angle closure glaucoma that gradually developed signs of Fuchs' uveitis (FU) in right eye after resolution of the attack. A 41-year-old female was started on oral topiramate for migraine following which she developed bilateral acute angle closure glaucoma and uveitis. She improved with topical and systemic steroids. As the attack resolved, her right eye started developing classical features of FU which were initially confused with viral uveitis. Patient was followed-up without steroids for 2 years. She remained asymptomatic in right eye and healthy systemically proving diagnosis of FU. We recommend high index of suspicion for FU in an asymptomatic low-grade uveitis even though typical features of FU are absent initially. Few weeks of observation may allow FU to manifest on its own, which will prevent unnecessary investigations and treatment.