Charles Bonnet syndrome: case presentation and literature review

Charles Bonnet syndrome (CBS) is an under-recognized and under-reported disorder that involves visual hallucinations in visually impaired individuals. These patients have intact cognition, do not have hallucinations in any other sensory modalities, and retain insight into the unreal nature of their hallucinations.

Two case reports are presented. Case 1 is a 79-year-old man who presented with a 6-month history of hallucinations. Case 2 is an 86-year-old man who presented with a 2-month history of hallucinations. Both patients are legally blind from age-related macular degeneration. In both cases, the ocular examinations were otherwise unremarkable. A workup for other pathological causes of visual hallucinations was negative for both patients. They were given the diagnoses of CBS and were counseled. No other intervention was indicated at that time.

Optometrists should be aware of the potential for visual hallucinations in patients with visual impairment. Early recognition by clinicians of the symptoms of CBS, and sharing proper information, treatment, and advice, can alleviate distress or suffering experienced by patients with CBS.