Transient Intraocular Pressure Elevation During Modified Electroconvulsive Therapy in an Elderly Patient with Schizophrenia and Primary Open-Angle Glaucoma: a case report

Background: Modified electroconvulsive therapy (MECT) is a widely used treatment for schizophrenia. Glaucoma, a common ophthalmic condition, is characterized by elevated intraocular pressure (IOP). Although MECT has no absolute contraindications, its safety in patients with comorbid glaucoma is not well established, and reports of IOP changes during MECT in such patients are scarce. Case Presentation: We report the case of a 75-year-old woman of Han Chinese ethnicity with a 13-year history of emotional instability and a 3-year diagnosis of schizophrenia. She was admitted due to a relapse of psychotic symptoms. After the third session of MECT, she developed elevated IOP (right eye 12.1 mmHg, left eye 26.8 mmHg). An ophthalmology consultation diagnosed primary open-angle glaucoma (POAG). IOP was monitored during subsequent MECT sessions and gradually normalized (right eye 10.2 mmHg, left eye 11.5 mmHg after the eighth session) despite continued treatment. The patient’s psychiatric symptoms improved markedly. Conclusion: MECT may be safely administered to elderly patients with schizophrenia and comorbid POAG under close ophthalmologic monitoring. Transient IOP elevation can occur but does not necessarily warrant treatment discontinuation. Baseline IOP measurement and monitoring during the course are recommended to mitigate the risk of acute glaucomatous complications.