Charles Bonnet Syndrome (CBS)

Understanding Visual Hallucinations in Vision Loss

Neurology

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Last updated: Mar 24, 2025

What Is Charles Bonnet Syndrome?

Charles Bonnet syndrome is a condition where people with vision loss experience visual hallucinations while being mentally healthy. These hallucinations are purely visual and do not involve other senses.

Key Features

  • Occurs in people with significant vision loss
  • Hallucinations are only visual
  • Patient maintains complete awareness that the hallucinations aren't real
  • Does not indicate mental illness or cognitive decline

Common Hallucination Types

  • Simple patterns:

    • Geometric shapes
    • Grid-like patterns
    • Lines or dots
  • Complex images:

    • Faces or people
    • Animals
    • Buildings
    • Landscapes
    • Objects

Risk Factors

  • Significant vision loss (especially in older adults)
  • Conditions such as:
    • Macular degeneration
    • Glaucoma
    • Diabetic retinopathy
    • Cataracts

Management Strategies

  1. Environmental Changes

    • Improving lighting
    • Increasing social interaction
    • Maintaining good sleep patterns
  2. Coping Techniques

    • Blinking rapidly
    • Moving eyes side to side
    • Walking to another room
    • Turning on more lights

When to Seek Medical Help

  • If hallucinations cause distress
  • When unsure about the diagnosis
  • If new symptoms develop
  • To rule out other medical conditions

Treatment Options

  • Usually no specific medication required
  • Education and reassurance
  • Treatment of underlying eye condition
  • Occasional use of medications in severe cases

Prognosis

  • Often improves with time
  • May come and go
  • Generally not harmful
  • Better managed with understanding and support

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