Prevalence and clinical characteristics of Charles Bonnet syndrome in patients with glaucoma

Charles Bonnet Syndrome (CBS) is characterized by visual hallucinations in individuals with acquired vision loss. Despite its potential impact on the patient's quality of life, CBS remains underdiagnosed and is often misinterpreted as a psychiatric illness. This study aims to investigate the prevalence and clinical characteristics of CBS in patients with glaucoma, also highlighting its correlation with visual acuity and severity of glaucoma.

A cross-sectional study was conducted on 200 patients diagnosed with glaucoma at a tertiary care center of western India. Patients were evaluated for CBS using a pre-designed questionnaire capturing demographic data, glaucoma profiles, and details about hallucinations. Statistical analysis was performed to ascertain the prevalence of CBS and its associations.

CBS was identified in 23 patients, resulting in a prevalence of 11.5%. Most affected individuals were aged 50-59 years, with a male-to-female ratio of 11:12. Most patients experienced simple visual phenomena, such as lines and light flickers. CBS was more prevalent in primary open-angle glaucoma (69.57%) compared to primary angle-closure glaucoma (30.43%). A significant proportion of patients reported that their hallucinations affected their emotional well-being and quality of life.

This study underscores the prevalence of CBS in glaucoma patients, even among those with relatively good visual acuity. Recognizing CBS is crucial for appropriate management and support, as it significantly impacts the psychosocial health of patients. Increased awareness and education for both patients and clinicians are essential to ensure improved patient outcomes in overall glaucoma care.

Despite its potential impact on the patient's quality of life, CBS remains underdiagnosed and is often misinterpreted as a psychiatric illness. It can occur even among those with relatively good visual acuity and can significantly affect the emotional well-being and quality of life of patients. Timely detection and patient counselling may help to minimize the negative consequences of this condition.