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Weird visual side effects?


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I'm on 175 mg. Topamax (and will be going to 200 mg. Saturday) for migraines. I originally started on 50 mg. and upped by 25 mg. a week till I reached this dose per my neurologist. I had most of the usual side effects, but they gradually disappeared when I hit the plateau at 150 mg.

That is, until last Saturday morning. I got up and went to uncover my bird (the one in my avatar) and noticed a weird visual artifact in my peripheral vision, trails kind of like you'd see on an LSD trip. I experimented a bit with my hand, and sure enough, trails. I rubbed my eyes a lot and after about 20 seconds, it went away. I thought nothing more of it till late that night, when it happened again. I was really tired and headed for bed, and it happened again, but only when I put my feet down. Each time a foot hit the floor, a footfall would jar loose a trail of something in my peripheral vision, like a door jam, the side of a couch, the bird cage.

It's happened every day again since then. It only happens when I'm tired, only upon rising and only in the late evening. Is this something I should be worried about? I don't feel any other weirdness going on. Should I mention this to my doctor?

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quote from our beloved crazymeds.com

Dry and/or itchy eyes along with assorted vision problems. Topamax also has a warning for rare forms of myopia and glaucoma, so if you get any sort of visual weirdness, have your eyes checked immediately! Fortunately discontinuing Topamax usually takes care of these issues, but you can't let your doctor just blow it off as an eye thing.

it is definately something you should mention to your doctor.  I, personally, don't think that you should just shrug it off.  Call your pdoc and let him/her know about this.  Even if it is in fact nothing to worry about, it is better to be safe than sorry, ya know?

stay well

~Ophelia

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I haven't been able to get through to my neurologist (damn HMO), three calls since yesterday. I want to start getting off Topamax now, can't wait. I am at 175 mg. now, how fast can I get off this? My eyes are hurting, my vision is getting worse by the day. But I honestly don't know how much of this is anxiety related and how much is actual vision problems. I feel like such a wreck today and I'm kind of freaking out that I waited so long and I hope I didn't screw up my eyes permanently.

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You have to be very careful going off, since Topamax is an anticonvulsant.  I'd imagine you'd have to go down at the same rate that you increased the medication - probably 25 at a time?

If you can't reach your doctor, maybe call your pharmacist and explain what's going on.  I don't know how serious the eye thing is vs the risks of going off the medication suddenly or quickly.  Have you tried contacting your GP?  If you can't reach your doctor, and can't get in to see someone else soon, and your eyes are hurting, you might have to go to an immediate care, or even the ER.  Sometimes, HMOs don't leave you any other option.

Yes, the Topamax rx information says that the problems associated with the weird eye thing, if untreated, can lead to permanent vision loss.  It says to discontinue as quickly as possible, according to the judgment of the doctor.

http://www.orthomcneil.com/products/pi/pdf...ax.pdf#zoom=100

see page 2 of 7

Maybe the vision stuff you're noticing is totally unrelated.  With me, we weren't for sure it was Topamax, but it's better safe than sorry.  And, with most people who experience visual problems on Topamax, there isn't any permanent damage.  Everything should go back to normal, healthy eyeball-land as soon as you are off.

Definitely don't stop taking it/drastically reduce your dose before talking to a doctor, preferably your neurologist.  You don't want to have a seizure.  That's even worse than myopia.

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Okay, I finally got hold of my neurologist. She dropped me from 175 mg. to 100 mg. immediately, and is referring me to an opthalmologist. In the meantime, I've developed splotchy vision with intermittent sparklies. I sure hope this goes away soon. My doctor thinks this may not be from the Topamax, but Topamax may have triggered something else. Does that make any sense? This was relayed through a nurse who couldn't say more, so I couldn't ask for details, so I don't know what that really means.

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I'm so glad you heard back from your doctor!  I don't know what the Topamax could have triggered indirectly to cause the visual stuff - maybe some neurological something, like migraine aura?  If it makes you feel any better, I went to an opthamologist less than a week after stopping Topamax, and my eyes were perfectly fine.  Within a day or two of stopping, all visual problems went away, and my brain came back to full power.

Good luck!  Let us know how it all turns out!

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Thanks. I've had migraine aura, this isn't it. I get double, triple vision, started in peripheral, now in front too. Trails, red/green colors, blotches, sparklies. Last night I had to go out driving, no choice. It's the last time I'm going to be doing that till this passes. I saw things that weren't there, bright flashes streaking around, blurry things moving around everywhere, on the road and in the air. I could barely tell what was real and what wasn't. A real trip and dangerous, good thing there was very light traffic. Still seeing all that stuff this morning but a lot less. I see more of it in low light and darkness.

I'm experimenting a bit with my eyes today. My right eye vision is really shot, left eye is much better (both used to be balanced). I've been having a lot of numbness and hot flashes mostly on the right side of my head and face since my neck/shoulder injury, so I think this is probably all related. Now I'm just waiting for that call, watching all the weird things in the air, and my new 3D computer screen (another weird visual artifact, some of the letters are floating above the others).

ADDED this evening just for the record: Trails and stuff still in the night tonight. Eyeball pressure down, but now noticing a lot of pain behind eyes, getting very tired eyes, keeping them closed a lot more during the day. Right eye vision got better as the day wore on. Yeesh, I hate this. Hope tomorrow is better.

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Bumping just to say that I'm still seeing trails and other visual artifacts in the evenings, nights and early mornings. Eyes still get tired very easily, especially in brightly lit rooms or in daylight, to the point of pain if I stay in them too long and don't close my eyes to rest up. Glad I can read again, even if only for a little while till I get tired; it's nice to not have double vision any more in the right eye. Still waiting for opthalmology appointment, still on 100 mg. Topamax lowered dose a day and doing relatively okay on it.

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Okay, I just got back from seeing the opthalmologist today. She says there's nothing wrong with my eyes or optic nerves. She thinks I'm having a new form of migraine, an "optical migraine", and is kicking me back to neurology because it's not an eye or optic nerve problem.

But something just doesn't make sense to me. I thought Topamax is supposed to work on migraines. If so, why would it have caused this new form of migraine?

I'm not even sure if this is a migraine I'm experiencing, as she says. I'm pretty certain it's Topamax-caused myopia, because at 150 mg. my right eye definitely went into double vision, and when I dropped back to 100 mg. my eyesight went back to normal within four days. When I mentioned this to the opthalmologist, she wasn't impressed and moved on.

If these events I'm having are migraines, where are the accompanying headaches? I seem to be experiencing only visual problems, no headaches, which is different than all my other kinds of migraines, and these events started only when I was on Topamax. I only see these visual artifacts in dim light or darkness. So am I supposed to believe I'm having migraines only in dim light, then? This just doesn't make any sense to me. Maybe I'm just missing something.

Anyway, that's what's happening now. I still see my "little friends", my visual disturbances, in dim light or darkness. I see afterimages, or ghosts of images, in daylight. I do have more than usual trouble with bright light since the onset of the visual problems, and if I stay out in bright light sunlight or even bright room light too long, I get headaches and eye pain. I mentioned this to the opthalmologist too, but she didn't seem to think too much of this either.

So now I go back I go to neurology, eventually. I feel like a damn ping pong ball.

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And just great. On top of all that, I just played my messages. I've been in workers comp hell (that's another story) due to a work injury (neck and shoulder) for a year now. My employer is going to cut me loose on Oct. 1, and they're also cutting my health insurance. Meaning, no more access to my HMO. No more Topamax. No more Atenolol. No more Wellbutrin. No more Opthalmology or Optometry. No more Neurology. No more anything except for what I'm getting for my work injury.

I guess I could convert to COBRA, if I had the $500 a month to pay into the plan, but workers comp pay just barely makes the bills as it is. I'm really pissed right now. I don't know what I'm gonna do.

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  • 3 weeks later...

How did everything work out?  My little post-notify thing didn't notify me that there was more.  I am sorry about the insurance thing.  My doctor once told me that you can appeal to the drug companies for help, if you can't afford your medicine.

I get migraines sans headache, and the main symptoms are visual, but they are like the classic migraine visual aura.

What does the neurologist say?

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