by Dan Roberts
September 2004
This syndrome is characterized by visual hallucinations in people who have a sudden change in vision such as that brought on by macular degeneration. Named after the man who first described it in 1780, it was later defined as “persistent or recurrent visual pseudohallucinatory phenomena of a pleasant or neutral nature in a clear state of consciousness” (Damas-Mora, 1982).
An estimated 13% of patients with macular degeneration experience CBS, and the condition may be aggravated by other circumstances, such as sensory deprivation (i.e. living alone), diminished cognitive abilities, stroke, aging, depression, or bereavement (eg. “seeing” a deceased spouse).
People who experience hallucinations should undergo a thorough eye exam, since treatment for visual conditions may help to diminish the problem. A full dementia work-up is also advised in order to eliminate the possibility of neurological disorders.
The following treatments are used as necessary with patients showing CBS symptoms:
- Treatment of vision disorders
- Treatment of psychiatric problems, especially depression
- Grief counseling
- Increasing social stimulation
- Medication with haloperidol (Haldol) or anticonvulsants
It is important to keep in mind that CBS is not a psychotic condition, and that it is not a serious mental illness. Most people who experience it report that their hallucinations are positive, and even pleasant, such as colorful flowers or dancing children. It is also important that friends and family members understand that this is a normal occurrence in many visually-impaired people, and that they need to approach it with empathy and a good sense of humor.
For an audio/visual presentation on Charles Bonnet syndrome, visit http://www.mdsupport.org/nsg/cbs/audio_hi.mp3
For personal support, visit Charles Bonnet Syndrome Foundation
Principal source: Lylas G. Mogk, M.D.