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Charles Bonnet Syndrome
Menkhaus S., Behrens-Baumann W.,
Otto-von-Guericke-Universität Magdeburg, Universitäts-Augenklinik (Magdeburg)
Purpose: The Charles Bonnet Syndrome (CBS) is characterized by the presence of complex visual hallucinations in psychologically normal people. It occurs frequently in elderly, visually handicapped patients.
Case reports: Three patients are presented. The age ranged between 75 and 85 years old and they had impaired vision because of age-related or myopic macular degeneration. They reported about mostly coloured optic hallucinations like ornaments, frames and heads. All patients were aware of the unreal nature of their hallucinations. A neurological examination of two patients revealed no abnormalities. No patient required treatment.
Discussion: Several studies showed that 12 to 13% of people with impaired vision have optic hallucinations with different frequency. Most patients describe a large variety of hallucinations. Neurologic and psychiatric deseases should be excluded before making a diagnosis of CBS. CBS has little impact on the general feelings of well-being in the majority of patients, but all of them are glad to be informed that their extraordinary experiences are no sign of mentally illness. If one patient is disturbed by the frequent occurrence of sights a treatment with carbamazepine is possible in coordination with a neurologist or psychiatrist.
Conclusions: Optic hallucinations are not rare among patients with low vision. Many patients do not consult a doctor about CBS out of fear of being considered insane. It is recommended that all patients with low vision are questioned about occurrence of visual hallucinations. Many patients will benefit from a discussion about these phenomena and the assurance of their harmless nature. Treatment of CBS is rarely needed.