Charles-Bonnet syndrome occurs in patients with loss of vision (usually due to ocular pathology) who experience visual hallucinations.
Although numerous causes are seen (any cause of gradual ocular visual failure can theoretically produce Charles Bonnet syndrome, as can other locations for visual loss, e.g. optic chiasm, optic radiation, and occipital lobes), the most common is macular degeneration 1; representing how prevalent this condition is. Therefore, not surprisingly, elderly patients are most commonly affected 1.
Patients typically experience hallucinations when awake with eyes open, typically in the evenings or at night 1. The hallucinations themselves are not stereotyped (i.e. they vary from day to day), and patients have insight into the fact that these are not real, and tend not to be distressed by them 1.
Imaging of the brain is two-fold:
- 1. Manford M, Andermann F. Complex visual hallucinations. Clinical and neurobiological insights. Brain. 1998;121 ( Pt 10) (10): 1819-40. doi:10.1093/brain/121.10.1819 - Pubmed citation
- 2. Pang L. Hallucinations Experienced by Visually Impaired: Charles Bonnet Syndrome. Optometry and vision science : official publication of the American Academy of Optometry. 93 (12): 1466-1478. doi:10.1097/OPX.0000000000000959 - Pubmed
- 3. Winton-Brown TT, Ting A, Mocellin R, Velakoulis D, Gaillard F. Distinguishing Neuroimaging Features in Patients Presenting with Visual Hallucinations. AJNR. American journal of neuroradiology. 37 (5): 774-81. doi:10.3174/ajnr.A4636 - Pubmed