Charles Bonnet Syndrome: Seeing Hallucinations With Healthy Thinking

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Charles Bonnet Syndrome occurs in individuals with partial or complete vision loss who begin to see hallucinations—patterns, people, animals, or landscapes—that aren’t real.

Unlike psychiatric hallucinations, patients with CBS usually recognize that what they see is not real.

Causes

• Vision Loss: Triggered by conditions such as age-related macular degeneration, glaucoma, cataracts, diabetic retinopathy, or stroke-related damage.

• Brain Response: With reduced visual input, the brain fills in the gaps using stored images or creating new ones

Types of Hallucinations:

• Simple: geometric shapes, grids, or patterns.

• Complex: people, animals, landscapes, or even fantastical creatures like dragons.

• Characteristics:

-Can be in color or black-and-white.

- May last seconds to hours.

- Do not involve sound, touch, or smell.

- Awareness: Most patients know the hallucinations are not real.

Management

- Lighting adjustments

- Eye movements

- Relaxation: Stress and fatigue worsen CBS

- Social support

Charles Bonnet Syndrome is not a mental illness but a side effect of vision loss. Unfortunately, many patients suffer in silence, fearing stigma. Awareness among patients, families, and healthcare providers is essential to ensure reassurance, proper diagnosis, and coping support.

What do you know about this syndrome? Have you seen any patients with this??

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The fact that patients are aware their hallucinations are not real makes CBS medically unique and clinically important. I find it fascinating how the brain tries to compensate for reduced visual input by creating images and patterns. The explanation about simple and complex hallucinations was interesting. I have not seen a patient with CBS personally, but learning about such neurological conditions helps us understand the connection between the brain and sensory systems better.

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Informative read. Never encountered such case.

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