Topamax and optic nerve damage

For about a month, I've been on a low dose (25 mg) of Topamax, as both a mood stabilizer and a migraine preventative, but I've noticed some slight changes in my vision over the last few weeks.  My eyes seem to tire easily, I sometimes feel pressure and pain in them, and my left eye in particular feels often blurred or 'filmy.'  Today I went to see my eye doctor and she noticed that my left optic nerve was slightly swollen and asked for further tests, though the pressure in my eyes seems to be norma.  Is it likely that such a small dose of Topamax would cause these visual problems?  Should I stop taking the medication?  Thank you for a prompt reply--I'm very concerned.  

[Michael J Kutryb, MD]

I don't believe the topamax would cause optic nerve swelling as far as I know.  The real issue is if you truly have optic nerve swelling or not.  If it is real, then a fairly extensive workup would need to be undertaken including a brain MRI.  I can tell you that sometimes patients have pseudopapilledema or a nerve that looks swollen but is not in reality and sometimes it is real papilledema that can be a sign of a serious problem.  Please keep in close contact with your ophthalmologist and maybe consider trying to get off topamax anyway due to the many possible side effects.

MJK MD