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Charles Bonnet syndrome
Epidemiology:
- 10-13% of patients with visual impairmment (< 20/60 bilateral acuity) experience visual hallucinations
Pathology:
- retinal &/or cortical lesions impairing vision
Clinical manifestations:
- visual hallucinations
- may be simple (diamonds or rectangles)
- more often complex (animals, children, entire scenes)
- insight intact (or partially intact)
- patients are aware that the hallucinations are not real
- nonetheless, the hallucinations appear real to the patient
- visual impairment (see epidemiology)
- lack of organic brain disease or psychiatric disorder
Complications:
- a patient who loses insight may become very distressed by the hallucinations
Management:
- supportive therapy
- education: hallucinations a sign of visual impairment not mental illness
- low dose antipsychotic may be helpful for patients who lose insight & become distressed
General
syndrome
eye disease (ophthalmopathy)
References
- Geriatric Review Syllabus, 7th edition
Parada JT et al (eds)
American Geriatrics Society, 2010
- Le JT, Peprah D, Agron E et al
Associations between Age-Related Eye Diseases and Charles Bonnet Syndrome
in Participants of the Age-Related Eye Disease Study 2: Report Number 26.
Ophthalmology. 2022 Feb;129(2):233-235.
PMID: 34419554 PMCID: PMC8792186 Free PMC article.