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Charles Bonnet syndrome in children
1Department of Ophthalmology, West Virginia University, Morgantown 26506-9193, USA.
Insights
Charles Bonnet syndrome (CBS) causes visual hallucinations in visually impaired individuals. This report details CBS in two children with cone-rod dystrophy, noting their symptoms mirrored adult experiences.
Area of Science:
- Ophthalmology
- Neurology
- Pediatrics
Background:
- Charles Bonnet syndrome (CBS) involves visual hallucinations in psychologically healthy individuals with vision loss.
- CBS is well-documented in adults but less characterized in pediatric populations.
- This study focuses on CBS presentation in children with specific visual impairments.
Purpose of the Study:
- To describe the occurrence and characteristics of Charles Bonnet syndrome in two children.
- To compare pediatric CBS symptoms with those reported in adult cases.
- To investigate the prevalence of CBS symptoms in a broader group of visually impaired children.
Main Methods:
- Detailed case reports of two children diagnosed with cone-rod dystrophy and experiencing visual hallucinations.
- In-depth interviews with the children regarding the nature of their hallucinations.
- Questioning of sixteen additional visually impaired children about CBS symptoms.
Main Results:
- Two children with cone-rod dystrophy developed complex visual hallucinations (geometric shapes, people, buildings) after rapid vision loss between ages 6-8.
- The children's hallucinations were similar to adult CBS descriptions, often interesting or entertaining, and rarely frightening.
- None of the sixteen additional visually impaired children reported experiencing hallucinations.
Conclusions:
- Charles Bonnet syndrome can manifest in children with significant vision loss, presenting similarly to adults.
- Early and rapid vision loss appears to be a key factor in the development of CBS in pediatric cases.
- Further research is needed to fully understand the prevalence and characteristics of CBS in children.
Abstract:
Charles Bonnet syndrome (CBS) is characterized by the presence of complex visual hallucinations in psychologically healthy but visually impaired people. It has been well described in the adult population but has been less well characterized in children. This report describes CBS in 2 children, both of whom had diagnoses of cone-rod dystrophy. After previously normal visual experience, each underwent rapid visual deterioration between 6 and 8 years old. Formed visual hallucinations were noted shortly after loss of vision. The children's symptoms were identical to those described by adults with CBS. Formed visual phenomena included geometric shapes, people, and buildings. Images, which were both stationary and in motion, were described as interesting or entertaining and only rarely as frightening. No other senses were affected (no auditory component). Sixteen additional children with diseases of the eye or optic nerves were questioned about symptoms of CBS, including children with congenitally decreased vision, children with slowly progressive visual loss but current vision better than 20/200, and children with early normal vision who had profound vision loss before 4 years old; all these children denied hallucinations.
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