Topiramate (TPM) is a sulfonamide drug with multiple modes of action. It inhibits carbonic anhydrase, blocks sodium channels, enhances potassium channels, and stimulates postsynaptic gamma-aminobutyric acid (GABA) receptors. Pharmacists Joe Gardocki and Bruce Maryanoff synthesized TPM for the first time in 1979. The FDA did not approve it for medical use in the US until 1996. Around 2004, it was authorized for the prevention of migraine headaches. TPM, like any medication, has several side effects. Common aftermaths include weight loss, diarrhea, dizziness, sleepiness, fatigue, and coordination issues. Some people may experience mental health issues like memory problems, confusion, and speech or language difficulties. The most well-known ocular side effects of TPM are choroidal effusion syndrome, angle-closure glaucoma, and myopic shift. Aside from these, other ophthalmic adverse effects may arise in some people, including retinal problems, uveitis, visual field defects, myokymia, and neuro-ophthalmology complications. If such complications are not identified and treated promptly, they can be severe and vision-threatening, potentially leading to permanent blindness. TPM's application as a standalone and adjunctive therapy has increased over time. In 2019, more than 10 million prescriptions of TPM were issued. Due to its extensive use, medical professionals and patients must be aware of its potential repercussions, especially ophthalmic issues. The current review paper likewise makes a step in this direction. This article's primary purpose is to educate readers by providing a comprehensive assessment of the research on TPM's ocular side effects. All the information has been collected via a thorough search of the Google Search Engine and PubMed.

Retinal arterial macroaneurysms represent an acquired vascular irregularity that is primarily observed in the elderly population. The high variability surrounding the clinical presentation of this condition makes the initial diagnosis challenging. Employing several diagnostic techniques including fundus fluorescence angiography, optical coherence tomography, and optical coherence tomography angiography ensures that any hemorrhages secondary to macroaneurysms rupture are identified promptly. This is crucial for appropriately managing the case and ensuring a good prognosis. Here, we present a case of a multilayered hemorrhage secondary to a ruptured retinal arterial macroaneurysm managed with a pars plana vitrectomy with gas tamponade and we aim to highlight the recent advancements in diagnosis and management of this condition.

Eye problems are a common presentation in primary care and they are the presenting problem in about 2–3% of all consultations. GPs are responsible for diagnosing eye conditions and making appropriate specialist referrals. The tools usually available in general practice, such as Snellen charts, penlights, and direct ophthalmoscopy, are sufficient to diagnose most eye disease. This article aims to help GPs approach eye examination in an organised, logical fashion. This article will outline how to perform each step of the examination and the diagnosis of common eye conditions including those that need immediate referral to a specialist. A fictional case scenario is used to illustrate the importance of a good history and accurate eye examination in the diagnosis and management of eye disease.