A Case of Complete Recovery of Visual Loss Associated With Electroconvulsive Therapy

Purpose: To report a case of complete recovery within 1 day of cortical blindness associated with electroconvulsive therapy (ECT). Case summary: A 15-year-old girl, who had no ophthalmologic disease, complained of bilateral visual loss immediately after ECT. At the first ophthalmologic examination, best corrected visual acuity was 0.03 in both eyes. Findings of anterior segment and fundus, movement of external ocular muscles, and pupillary light reflex were normal. Visual field examination showed generalized reduction of sensitivity and increased fixation loss in both eyes. Optical coherence tomography revealed no abnormalities. Electroretinography was normal, and a slightly prolonged latency of P100 was noted in the right and left flash visual evoked potentials. Without any specific treatment, the patient's vision improved gradually after 18 hours of ECT and was recovered completely, with vision of 1.0 in both eyes the next day. There were no abnormalities in visual evoked potentials or the visual field. Conclusions: Transient visual loss can occur after ECT, because of cortical blindness by transient cerebral ischemia, and can be recovered completely without specific treatment.