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Introduction;   AcuteAngle Closure Glaucoma (AACG) is a well recognized side effect of topiramate(TPM). This is an ocular emergency and receivesdistinction due to its acute presentation and call for immediate treatment.Althoughthere are accessible data from adult studies, no substantial evidence availableon TPM-induced-AACG in children.  Objectives; Todemonstrate topiramate use and the risk of glaucoma development in children Method Analytical,retrospective cohort study.Allpatients who are on TPM (under predefined criteria) and an age and sex matchednon-exposed group were screened by a blinded examiner. Data Analysis; Exposed group (n=123), mean age7.9-years, males-52.8%, non-exposed group (n=119). 47/123 (38%) on TPM had anelectro-clinical-syndromic diagnosis while 54.4% had non-syndromic-epilepsies. 12/123(9.7%) were on TPM monotherapy, whereas 46.3% were on two Anti-Epileptic-Drugs(AEDs) and 44% were on three or more. Mean treatment duration for TPM was 19.5-months(range=0.5-72-months), mean starting dose 1.6mg/kg/day (range=0.6-3mg/kg/day)and a maintenance dose of 3.6mg/kg/day (range=0.8-8.5mg/kg/day). There was nosignificant correlation between the treatment duration, starting dose or themaintenance dose of TPM and mean Intra-Ocular-Pressure (IOP). On directquestioning 9/123 had symptoms (eye-pain=04, excessive tearing=03, visualdisturbance=02) however had no raised IOP. None of the parents were aware ofthe warning symptoms of AACG. There was no significant difference between themean IOP of exposed versus the non-exposed.  Conclusions/suggestions; Topiramate-induced-AACG is an uncommonside effect among children (0/123); clinical symptoms could be non-specific, suggestfurther (multicenter) studies including larger population size forconfirmation.

Topiramate; Intra-ocular pressure; Acute angle closure glaucoma