Topiramate-Induced Bilateral Acute Angle Closure in a Healthy Young Female
Bibliographic record
Abstract
Topiramate is a widely prescribed medication for epilepsy, migraine prophylaxis, and weight management, but it can rarely cause acute bilateral angle closure with myopic shift. We describe a healthy 35-year-old woman who developed sudden bilateral painful red eyes, blurred vision, and a myopic shift within one week of initiating topiramate. Examination revealed shallow anterior chambers, elevated intraocular pressure, and iridocorneal touch bilaterally. Prompt discontinuation of topiramate led to full resolution. Laser peripheral iridotomies (LPIs) were performed while the etiology was uncertain, and are not typically required in medication-induced effusion-related angle closure. This case underscores that cycloplegia and drug cessation are the key interventions, while LPI may be performed only when the underlying mechanism is unclear. This case highlights the importance of recognizing medication-induced angle closure and distinguishing it from primary pupillary-block mechanisms to ensure timely, vision-saving management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".