Page 13 - 21st Century Perspective - Glaucoma Supplement

or weight loss, the patient should just unilaterally discontinue using the drug and notify the prescriber
as soon as it is practical to do so. We also need to relax the ciliary body; thus, a cycloplegic agent,
such as cyclopentolate is used. Never use pilocarpine because as an anticholinergic, it can induce

slight swelling of the ciliary body, which is the exact process we are trying to counter. Next,
depending on how high the IOP has risen, timolol and/or brimonidine can be administered.
Prostaglandins are much slower onset agents and rarely have a role in any acute IOP rise.

Last, there is no role for laser photoiridotomy in the treatment of topiramate-induced angle-closure.
Therefore, this is a clinical condition that a competent optometrist can fully manage and would not
require management from an ophthalmic surgeon. Furthermore, such events do not cause glaucoma
but cause only a transient rise in IOP. Interestingly, and distinct from anatomic angle-closure, there
is usually little or no pain associated with this condition, and the cause for patient presentation is the

induced myopia, and thus blurred vision is typically the chief complaint.

13