Electroconvulsive therapy in a patient with glaucoma

Electroconvulsive therapy (ECT) is associated with a brief rise in intraocular pressure (IOP). The significance of this in glaucomatous patients is unknown. We present a patient with bilateral glaucoma status after surgery in the right eye who underwent IOP monitoring during 1 of his ECT treatments. Baseline eye pressures were normal at 16 mm Hg and 18 mm Hg immediately before the treatment in the right and left eyes, respectively. Fifteen seconds after seizure induction, there was an approximately 5 mm Hg rise in IOP in the left eye, which lasted approximately 5 minutes before returning to baseline. In the right eye, there was virtually no change in pressure during the seizure. Though further research would be helpful, this case provides evidence that in a glaucomatous patient controlled with medicines or surgery, ECT probably will not cause a significant rise in IOP.