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Published on: May 25, 2020
Charles Bonnet syndrome in Asian patients in a tertiary ophthalmic centre
C S H Tan1, V S Y Lim, D Y M Ho
1The Eye Institute at Tan Tock Seng Hospital, National Healthcare Group, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore. Colintan_eye@yahoo.com.sg
Insights
Charles Bonnet syndrome (CBS) affects 0.4% of Asian patients in a tertiary eye center. Hallucinations were varied, often negatively perceived, and rarely discussed with doctors.
Area of Science:
- Ophthalmology
- Neurology
- Epidemiology
Background:
- Charles Bonnet syndrome (CBS) involves visual hallucinations in people with vision impairment.
- Epidemiological data on CBS in Asian populations is limited.
Purpose of the Study:
- To determine the prevalence of CBS in Asian patients at a tertiary ophthalmic center.
- To characterize the visual hallucinations experienced by CBS patients.
Main Methods:
- A standardized questionnaire identified 1077 patients aged 50+ with formed visual hallucinations.
- Detailed interviews confirmed CBS diagnosis based on established criteria.
Main Results:
- Four patients (0.4%) were diagnosed with CBS (2 Chinese, 2 Indian; average age 76.3).
- Underlying eye conditions included cataracts and glaucoma.
- Hallucinations were diverse; 75% had negative reactions, and only one patient reported symptoms to a doctor.
Conclusions:
- This study reports the first epidemiological data on CBS in Asian patients.
- The prevalence (0.4%) appears lower than in non-Asian populations.
- Hallucination characteristics align with previous findings.
Aims:
To describe the epidemiology of Charles Bonnet syndrome (CBS) among patients in an Asian tertiary ophthalmic centre and to describe the characteristics of the hallucinations experienced.
Methods:
1077 consecutive patients aged 50 years and above were asked a standardised question to determine if they had ever experienced formed visual hallucinations. All patients who experienced these symptoms were further interviewed using a detailed, standardised questionnaire to ascertain if they met the diagnostic criteria established for CBS.
Results:
There were 491 men (45.6%) and 586 women (54.4%). The best corrected visual acuity ranged from 20/20 to light perception in the better seeing eye and from 20/20 to no light perception in the worse seeing eye. Four patients (0.4%) were diagnosed with CBS; two men and two women. There were two Chinese and two Indians. The average age of the CBS patients was 76.3 years (range 65-90 years). Two patients had cataracts, one had glaucoma, and one had both cataracts and glaucoma. A wide variety of visual hallucinations were reported. Three out of four patients experienced a negative reaction to their hallucinations. Only one patient had discussed his symptoms with a doctor.
Conclusions:
This is the first report on the epidemiology of CBS in Asian patients. The prevalence rate of CBS (0.4%) is slightly lower than in comparable studies in non-Asian populations. The nature of the hallucinations experienced were similar to those previously reported.
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