Materiały źródłowe

• #1 Charles Bonnet Syndrome – StatPearls – NCBI BookshelfTwitterFacebookLinkedInGitHubNCBI Insights BlogTwitterFacebookYoutube

  https://www.ncbi.nlm.nih.gov/books/NBK585133/

  Charles Bonnet syndrome (CBS) is a medical condition in which complex visual hallucinations occur concurrently with visual changes, specifically visual field loss or visual acuity loss. […] CBS often goes unrecognized and misdiagnosed with early dementia or psychosis. […] A detailed and systemic history is essential to rule out the existence of hallucinations. […] Upon ruling out hallucinations secondary to an underlying neurological condition or medication, the next step is confirming the presence of vision impairment or loss through a thorough ophthalmologic evaluation with visual field testing. […] In summary, a diagnosis of CBS can be made in individuals having only visual hallucinations in the absence of neurologic abnormalities while in the presence of known vision impairment or loss.

• #2 Charles Bonnet syndrome – NHS

  https://www.nhs.uk/conditions/charles-bonnet-syndrome/

  Charles Bonnet syndrome is a condition where you see things that are not real (hallucinations). It can happen if you’ve lost a lot of your sight. It’s not caused by a mental health problem or dementia. […] The main symptom of Charles Bonnet syndrome is seeing things that are not real (hallucinations) after losing a lot of your sight. […] It’s important to rule out more serious conditions that cause hallucinations. […] There’s currently no cure for Charles Bonnet syndrome, but over time the hallucinations usually happen less often. […] A GP, optician or ophthalmologist (eye doctor) can refer you to a specialist low-vision service for advice about things to help with your sight. […] Charles Bonnet syndrome is not caused by a mental health problem or dementia.

• #3 Charles Bonnet syndrome • LITFL • Medical Eponym Library

  https://litfl.com/charles-bonnet-syndrome/

  Charles Bonnet syndrome (CBS) is a condition in which visual hallucinations occur in cognitively intact patients and in the absence of any other psychotic features or any evidence of a psychiatric disorder. […] Although the syndrome is usually associated with visual impairment, its presence is not essential for diagnosis. […] CBS can occur at any age, but sufferers are usually elderly. […] The precise pathophysiology of CBS is not known and there are no controlled clinical trials studying effective treatments for CBS. […] Apart from prescribing pharmacotherapies such as antipsychotics and anticonvulsants, the role of a clinician is to reassure the patient and to provide information about the syndrome. […] Morsier coined the eponym Charles Bonnet syndrome originally to describe visual hallucinations in the elderly in the absence of cognitive impairment and peripheral ophthalmopathy.

• #4 Charles Bonnet Syndrome – Rare Awareness Rare Education

  https://rareportal.org.au/rare-disease/charles-bonnet-syndrome/

  Charles Bonnet syndrome (CBS) is a vision-related condition in which individuals see images that are not actually present (phantom images) due to decreasing or loss of vision. CBS is a distinct clinical condition, as recognised by the World Health Organization (WHO), and is not due to psychosis, dementia, or other neurodegenerative issues. It is important for health professionals to be aware of CBS and help individuals to understand that it is a vision-related condition and not a mental condition. […] There is no definitive diagnostic test for Charles Bonnet syndrome (CBS). CBS is known as a diagnosis of exclusion, which means that all other possible causes (such as medication side effects, electrolyte imbalance, neurological or psychiatric causes) need to be ruled out. […] Healthcare professionals involved in the diagnosis and treatment of Charles Bonnet syndrome may include general practitioners (GP), neurologists, psychiatrists, geriatricians and ophthalmologists. The need for different healthcare professionals may change over a person’s lifetime and extend beyond those listed here.

• #5 Charles Bonnet Syndrome and Visual Hallucinations – Eye Doctor, Eye Care in Northeast Texas, Louisiana, and Arkansas

  https://www.familyeyecareclinic.net/blog/643-charles-bonnet-syndrome-and-visual-hallucinations

  Charles Bonnet Syndrome is now the term used to describe simple or complex hallucinations in people who have impaired vision. […] The prevalence of Charles Bonnet Syndrome among adults 65 years and older with significant vision loss is reported to be between 10% and 40%. […] If there is a reversible cause of decreased vision, such as significant cataract, then once the decreased vision is treated, the hallucinations should stop. […] If you experience any of these symptoms, please get evaluated by your eye doctor to make sure there is not a treatable eye condition.

• #6 Charles Bonnet Syndrome: Causes, Symptoms, and Treatment

  https://patient.info/eye-care/charles-bonnet-syndrome

  Charles Bonnet syndrome diagnosis involves considering CBS as a likely cause if you experience visual hallucinations. […] In order to make the diagnosis the doctor will talk about your medical history, perform an eye examination. Some neurological and memory tests may also be done. This is to rule out some other conditions which can also cause visual hallucinations. […] CBS has nothing whatsoever to do with dementia and is entirely due to loss of sight. […] The condition is believed to occur in 10-15% of all people with moderate visual loss and up to 60% of people with severe visual loss. […] There are no specific tests for CBS.

• #7 Prevalence of Charles Bonnet syndrome in low vision: a systematic review and meta-analysis – Subhi – Annals of Eye Science

  https://aes.amegroups.org/article/view/6793/html

  The authors found that 63% of these visually impaired patients admitted to having experienced complex hallucinations, whereas none in the control group had any complex hallucinations. […] The random-effects pooled prevalence of CBS in low vision patients was 19.7% (95% confidence interval: 13.8% to 26.4%). […] In this systematic review and meta-analysis of 11 studies on patients with low vision, we find that the prevalence of CBS can be summarized to 19.7%. […] Extrapolating this estimate number of individuals with visual impairment highlight that CBS is no rare condition and that CBS warrants further attention from ophthalmologists as well as healthcare stakeholders.

• #8 Charles Bonnet Syndrome Present in 26% of Low Vision Patients, Study Finds

  https://www.reviewofoptometry.com/news/article/charles-bonnet-syndrome-present-in-26-of-low-vision-patients-study-finds

  An investigation conducted in Germany explored the visual disturbance known as Charles Bonnet syndrome (CBS) in visually impaired people without mental impairment. To date, prevalence estimates have varied greatly. […] Included in the research were 194 patients with visual acuity 0.5 logMAR; 50 were eligible and agreed to participate. Of this low vision cohort, 26% were found to have CBS. […] Patients did not immediately realize the unreality of images in 46.2% of the cohort; however, insight into the unreality of images is a key feature often required for a CBS diagnosis also recognized in the literature. […] The authors believe the requirement that at least one complex image occurs alongside other, simpler hallucinations might be a useful tool to make an accurate differential diagnosis.

• #9 Charles Bonnet syndrome: forgotten but important – Pavilion Health Today

  https://pavilionhealthtoday.com/gm/charles-bonnet-syndrome-forgotten-but-important/

  Charles Bonnet syndrome (CBS) is characterised by complex visual hallucinations generally against the background of visual impairment and in the absence of a neuropsychiatric disorder. […] CBS is a less frequently diagnosed despite it being a common cause of such hallucinations. […] Universal diagnostic criteria for CBS has not yet been established. Hence, there has been disagreement over its exact diagnostic criteria since CBS does not fit exactly into current classification systems. […] The nearest ICD 10 diagnosis would be organic hallucinosis. In this condition, the clinical picture is dominated by persistent or recurrent hallucinations, usually visual or auditory, occurring in clear consciousness and insight may be preserved. […] In the absence of universal consensus, the diagnostic criteria set forth by Podoll, and by Gold and Rabins, are widely accepted.

• #10 Challenges of diagnosing and treating Charles Bonnet syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6105053/

  Consider Charles Bonnet syndrome in patients with optical hallucinations after occipital stroke. […] Charles Bonnet syndrome (CBS) is primarily diagnosed in patients with an ophthalmic disease but is also seen in stroke patients with hemianopsia. […] To date, no universally accepted diagnostic criteria for CBS exist. Most of the proposed diagnostic criteria require formed visual hallucinations in the psychologically normal elderly patient. […] Even though largely unrecognized in the daily hospital routine, CBS should be considered as a diagnosis of hallucinating patients in whom other causes of visual hallucinations were excluded. […] A mainstay of treatment is the reassurance of patients that these visual hallucinations are inherently benign and not a sign of a psychiatric disorder. […] However, the effectiveness of melperone on hallucinations has to be proved further in a larger cohort of patients with CBS.

• #11 Charles Bonnet Syndrome – Rare Awareness Rare Education

  https://rareportal.org.au/rare-disease/charles-bonnet-syndrome/

  Charles Bonnet syndrome (CBS) is a vision-related condition in which individuals see images that are not actually present (phantom images) due to decreasing or loss of vision. CBS is a distinct clinical condition, as recognised by the World Health Organization (WHO), and is not due to psychosis, dementia, or other neurodegenerative issues. It is important for health professionals to be aware of CBS and help individuals to understand that it is a vision-related condition and not a mental condition. […] There is no definitive diagnostic test for Charles Bonnet syndrome (CBS). CBS is known as a diagnosis of exclusion, which means that all other possible causes (such as medication side effects, electrolyte imbalance, neurological or psychiatric causes) need to be ruled out. […] Healthcare professionals involved in the diagnosis and treatment of Charles Bonnet syndrome may include general practitioners (GP), neurologists, psychiatrists, geriatricians and ophthalmologists. The need for different healthcare professionals may change over a person’s lifetime and extend beyond those listed here.

• #12 Charles Bonnet Syndrome – StatPearls – NCBI BookshelfTwitterFacebookLinkedInGitHubNCBI Insights BlogTwitterFacebookYoutube

  https://www.ncbi.nlm.nih.gov/books/NBK585133/

  Charles Bonnet syndrome (CBS) is a medical condition in which complex visual hallucinations occur concurrently with visual changes, specifically visual field loss or visual acuity loss. […] CBS often goes unrecognized and misdiagnosed with early dementia or psychosis. […] A detailed and systemic history is essential to rule out the existence of hallucinations. […] Upon ruling out hallucinations secondary to an underlying neurological condition or medication, the next step is confirming the presence of vision impairment or loss through a thorough ophthalmologic evaluation with visual field testing. […] In summary, a diagnosis of CBS can be made in individuals having only visual hallucinations in the absence of neurologic abnormalities while in the presence of known vision impairment or loss.

• #13 Eyes – Charles Bonnet syndrome | Better Health ChannelExternal LinkExternal LinkExternal LinkExternal LinkExternal LinkExternal LinkExternal LinkExternal LinkExternal Link

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/eyes-charles-bonnet-syndrome

  Charles Bonnet syndrome refers to the visual hallucinations caused by the brain’s adjustment to significant vision loss. […] Diagnosis of Charles Bonnet syndrome may include: your medical history, a physical examination, an eye examination, medical tests to rule out other causes of visual hallucinations.

• #14 SciELO Brazil – Charles Bonnet syndrome: characteristics of its visual hallucinations and differential diagnosis Charles Bonnet syndrome: characteristics of its visual hallucinations and differential diagnosis

  https://www.scielo.br/j/anp/a/39XtvZhdJ3vLngRSzP8P3Fq/?lang=en

  Objective: To present an eight-case serie of patients with Charles Bonnet syndrome (CBS). […] All patients were initially evaluated by an ophthalmologist and then submitted to a neurologic evaluation with exclusion of alternative psychiatric and neurologic diagnoses. […] A mean delay of 41.7 months occurred until diagnosis. […] Physicians who care for low vision patients should be aware of CBS and appropriately diagnose its hallucinations after exclusion of psychiatric and neurologic diseases. […] Patients were diagnosed with CBS based on the detection of a significant visual impairment combined with visual hallucinations considered unreal by the patient. […] Many etiologies need to be ruled out in order to confirm the diagnosis of CBS. […] A thorough report on prescription and illicit drugs must be taken as well as if the patient has stopped taking them and might be in a withdrawal syndrome.

• #15 EyeRounds.org: Charles Bonnet Syndrome

  http://eyerounds.org/cases/302-Charles_Bonnet.htm

  Charles Bonnet Syndrome is largely a clinical diagnosis, and patients who experience visual hallucinations in the classic clinical context of low vision with good insight into their condition may not need diagnostic testing. […] A careful review of medication lists for pharmacologic agents known to cause visual hallucinations, such as digoxin, sildenafil, or anticholinergics is also advised. […] Generally, CBS can be distinguished from other causes by a lack of other neurologic deficits and the presence of known ocular disease. […] In the case that a patient presents with symptoms suggestive of CBS, but without known eye disease, a full ophthalmologic exam should be performed. […] CBS is under-recognized and underdiagnosed, and several groups have advocated for screening in order to identify affected patients. […] One simple approach recommends utilizing a combination of indirect and direct questioning in all patients with underlying vision loss. […] If the patient is not forthcoming about a history of hallucinations, a more direct line of questioning can then be used.

• #16 Charles Bonnet syndrome: a condition of the visually impaired – Dhooge – Annals of Eye Science

  https://aes.amegroups.org/article/view/6863/html

  A major difficulty in studying the collective data on CBS lies within the variable definition, or lack thereof, of this syndrome. […] The pooled prevalence of almost 20% that was reported by Subhi et al. calls for systematic inquiry for presence of CBS among the visually impaired. We therefore would like to challenge you as an ophthalmologist. Pose the following question to your patients with a vision impairment in the range of 3/60-6/18: Have you ever seen things or images that you know were not actually present at that moment?

• #17 Charles Bonnet Syndrome – StatPearls – NCBI BookshelfTwitterFacebookLinkedInGitHubNCBI Insights BlogTwitterFacebookYoutube

  https://www.ncbi.nlm.nih.gov/books/NBK585133/

  Charles Bonnet syndrome (CBS) is a medical condition in which complex visual hallucinations occur concurrently with visual changes, specifically visual field loss or visual acuity loss. […] CBS often goes unrecognized and misdiagnosed with early dementia or psychosis. […] A detailed and systemic history is essential to rule out the existence of hallucinations. […] Upon ruling out hallucinations secondary to an underlying neurological condition or medication, the next step is confirming the presence of vision impairment or loss through a thorough ophthalmologic evaluation with visual field testing. […] In summary, a diagnosis of CBS can be made in individuals having only visual hallucinations in the absence of neurologic abnormalities while in the presence of known vision impairment or loss.

• #18 EyeRounds.org: Charles Bonnet Syndrome

  http://eyerounds.org/cases/302-Charles_Bonnet.htm

  Charles Bonnet Syndrome is largely a clinical diagnosis, and patients who experience visual hallucinations in the classic clinical context of low vision with good insight into their condition may not need diagnostic testing. […] A careful review of medication lists for pharmacologic agents known to cause visual hallucinations, such as digoxin, sildenafil, or anticholinergics is also advised. […] Generally, CBS can be distinguished from other causes by a lack of other neurologic deficits and the presence of known ocular disease. […] In the case that a patient presents with symptoms suggestive of CBS, but without known eye disease, a full ophthalmologic exam should be performed. […] CBS is under-recognized and underdiagnosed, and several groups have advocated for screening in order to identify affected patients. […] One simple approach recommends utilizing a combination of indirect and direct questioning in all patients with underlying vision loss. […] If the patient is not forthcoming about a history of hallucinations, a more direct line of questioning can then be used.

• #19 Charles Bonnet Syndrome: Symptoms, Causes, Treatment | Qwark

  https://qwarkhealth.com/conditions/charles-bonnet-syndrome

  Charles Bonnet Syndrome (CBS) is a medical condition that can cause visual hallucinations in people who have some degree of vision loss. […] Though there is no known cure for CBS, it is important to seek medical attention if you are experiencing symptoms to ensure an accurate diagnosis and to receive proper care. […] The diagnosis of Charles Bonnet Syndrome (CBS) is usually a clinical diagnosis based on symptoms that are described by the patient. However, tests may be used to rule out other possible causes of the symptoms, such as eye exams, blood tests, and brain imaging tests. […] CBS is typically diagnosed through an evaluation by a healthcare professional who specializes in eye disorders. The diagnostic process usually begins with a comprehensive eye exam, including visual acuity testing, examination of the retina and optic nerve, and visual field testing.

• #20 Charles Bonnet Syndrome: Symptoms and Treatment | Doctor

  https://patient.info/doctor/charles-bonnet-syndrome-pro

  Diagnosing Charles Bonnet syndrome involves considering it in an older patient who has vivid, elaborate and often stereotyped visual hallucinations (eg, groups of people or children, faces, wild animals and panoramic countryside scenes). […] There are no universally accepted diagnostic criteria. […] Partial sight (eg, due to macular degeneration, cataract or glaucoma) is also a factor in diagnosing CBS. […] An ability to modify the image or make it disappear by closing their eyes is noted in the diagnosis. […] A normal cognitive status is required for diagnosis. […] Absence of organic disease, psychosis, impaired conscious level, dementia (particularly Lewy body dementia), intoxication, metabolic abnormalities, and focal neurological illness is necessary for a proper diagnosis. […] If CBS is suspected but the patient has not been diagnosed with an eye problem, assess vision using a Snellen chart. […] If the vision is abnormal, refer to an optometrist or the local eye unit for a complete ocular examination including dilated fundus check.

• #21 Charles Bonnet syndrome: What it is, symptoms, and moreMedical News Today

  https://www.medicalnewstoday.com/articles/charles-bonnet-syndrome

  People with CBS tend to find their hallucinations bizarre but not often disturbing. […] There is no single test to diagnose CBS. Instead, doctors will talk with a person about their medical history and rule out other causes of visual hallucinations. These could include: mental health conditions, side effects from medications, neurological or brain conditions. […] However, CBS does not affect a person’s mental faculties or health. Despite there being no cure for CBS, doctors can help people reduce their hallucinations.

• #22 Charles Bonnet syndrome | Your Eye HealthFacebookYouTubeInstagramLinkedInPinterest

  https://www.guidedogs.org.uk/getting-support/information-and-advice/eye-conditions/charles-bonnet-syndrome/

  Charles Bonnet syndrome is a condition that causes visual hallucinations in people with sight loss and of a sound mind. […] It’s important to see your GP if you start to experience hallucinations. They’ll discuss your symptoms and help you get a diagnosis. […] A healthcare professional usually diagnoses Charles Bonnet syndrome after taking a complete medical history. If you start experiencing hallucinations, speak to your GP or ophthalmologist. […] To make a diagnosis, a doctor will: Ask about your medical history, including any eye conditions. Ask about your symptoms, including details of your hallucinations. Sometimes do tests such as neurological and memory tests to rule out other possible conditions that can cause hallucinations. […] If you experience hallucinations, see your GP as soon as possible. If you have an eye disease or condition that has led to visual loss, you may have Charles Bonnet syndrome. Your doctor will discuss your symptoms and want to rule out any other conditions.

• #23 Charles Bonnet Syndrome: Symptoms and Treatment | Doctor

  https://patient.info/doctor/charles-bonnet-syndrome-pro

  Diagnosing Charles Bonnet syndrome involves considering it in an older patient who has vivid, elaborate and often stereotyped visual hallucinations (eg, groups of people or children, faces, wild animals and panoramic countryside scenes). […] There are no universally accepted diagnostic criteria. […] Partial sight (eg, due to macular degeneration, cataract or glaucoma) is also a factor in diagnosing CBS. […] An ability to modify the image or make it disappear by closing their eyes is noted in the diagnosis. […] A normal cognitive status is required for diagnosis. […] Absence of organic disease, psychosis, impaired conscious level, dementia (particularly Lewy body dementia), intoxication, metabolic abnormalities, and focal neurological illness is necessary for a proper diagnosis. […] If CBS is suspected but the patient has not been diagnosed with an eye problem, assess vision using a Snellen chart. […] If the vision is abnormal, refer to an optometrist or the local eye unit for a complete ocular examination including dilated fundus check.

• #24 SciELO Brazil – Charles Bonnet syndrome: characteristics of its visual hallucinations and differential diagnosis Charles Bonnet syndrome: characteristics of its visual hallucinations and differential diagnosis

  https://www.scielo.br/j/anp/a/39XtvZhdJ3vLngRSzP8P3Fq/?lang=en

  Objective: To present an eight-case serie of patients with Charles Bonnet syndrome (CBS). […] All patients were initially evaluated by an ophthalmologist and then submitted to a neurologic evaluation with exclusion of alternative psychiatric and neurologic diagnoses. […] A mean delay of 41.7 months occurred until diagnosis. […] Physicians who care for low vision patients should be aware of CBS and appropriately diagnose its hallucinations after exclusion of psychiatric and neurologic diseases. […] Patients were diagnosed with CBS based on the detection of a significant visual impairment combined with visual hallucinations considered unreal by the patient. […] Many etiologies need to be ruled out in order to confirm the diagnosis of CBS. […] A thorough report on prescription and illicit drugs must be taken as well as if the patient has stopped taking them and might be in a withdrawal syndrome.

• #25 EyeRounds.org: Charles Bonnet Syndrome

  http://eyerounds.org/cases/302-Charles_Bonnet.htm

  Charles Bonnet Syndrome is largely a clinical diagnosis, and patients who experience visual hallucinations in the classic clinical context of low vision with good insight into their condition may not need diagnostic testing. […] A careful review of medication lists for pharmacologic agents known to cause visual hallucinations, such as digoxin, sildenafil, or anticholinergics is also advised. […] Generally, CBS can be distinguished from other causes by a lack of other neurologic deficits and the presence of known ocular disease. […] In the case that a patient presents with symptoms suggestive of CBS, but without known eye disease, a full ophthalmologic exam should be performed. […] CBS is under-recognized and underdiagnosed, and several groups have advocated for screening in order to identify affected patients. […] One simple approach recommends utilizing a combination of indirect and direct questioning in all patients with underlying vision loss. […] If the patient is not forthcoming about a history of hallucinations, a more direct line of questioning can then be used.

• #26 Charles Bonnet Syndrome: Symptoms, Causes, and TreatmentHealthline

  https://www.healthline.com/health/charles-bonnet-syndrome

  Charles Bonnet syndrome (CBS) is a condition that causes vivid hallucinations in people who suddenly lose all or part of their vision. […] To diagnose CBS, your doctor will likely give you a physical exam and ask you to describe your hallucinations. They may also order an MRI scan and check for any cognitive or memory-related issues to rule out any other conditions.

• #27 Visual Hallucinations: Charles Bonnet Syndrome – The Western Journal of Emergency Medicine

  https://westjem.com/case-report/visual-hallucinations-charles-bonnet-syndrome.html

  Although Charles Bonnet syndrome has no official diagnostic criteria, the features described are generally accepted and can be used as guidelines to make the diagnosis when appropriate. […] A patient presenting to the ED with symptoms suggestive of Charles Bonnet syndrome should receive basic laboratory tests, such as a metabolic panel and complete blood count along with neuro-imaging, typically with CT without contrast. […] Our patient had the characteristic features with her age and history of vision loss. She also had full insight into the fictional nature of her hallucinations and met the diagnostic criteria of Charles Bonnet syndrome discussed previously. […] Once the diagnosis of Charles Bonnet syndrome is made in the ED, the provider can reassure the patient and provide suggestions to suppress hallucinations as mentioned previously.

• #28 Charles Bonnet Syndrome: Symptoms, Causes, Treatment | Qwark

  https://qwarkhealth.com/conditions/charles-bonnet-syndrome

  The process for screening patients with suspected CBS involves a comprehensive medical evaluation that includes a detailed medical history, a neurological examination, and various vision tests. […] Brain imaging tests such as MRI and CT scans are typically used to rule out other possible causes of the visual hallucinations. However, since CBS is a clinical diagnosis based on symptoms, brain imaging tests are not typically used to diagnose CBS.

• #29 Charles Bonnet Syndrome – EyeWiki

  https://eyewiki.org/Charles_Bonnet_Syndrome

  Charles Bonnet Syndrome (CBS), named after the Swiss scientist who first described visual hallucinations in his grandfather in the 1970s, has three features: hallucinations, ocular pathology, and intact cognition. […] There is no standardized diagnostic criteria for CBS. One systematic review of 33 studies found that visual loss and the presence of formed or complex hallucinations were commonly included as key features. However, there is no consensus on other factors, including the severity of vision loss or the exclusion of confounding conditions or cognitive impairment. For example, CBS has been associated with dementia, but it is unclear if this is a confounder or a true association. As such, physicians should consider further screening for dementia or cognitive impairment in those with CBS symptoms.

• #30 A Man’s Visual Hallucinations: Charles Bonnet Syndrome, Not Dementia With Psychosis | Consultant360

  https://www.consultant360.com/articles/man-s-visual-hallucinations-charles-bonnet-syndrome-not-dementia-psychosis

  Charles Bonnet syndrome (CBS) describes the clinical syndrome of visual hallucinations in cognitively intact but visually impaired patients. Low patient disclosure, a lack of awareness among health care providers, inadequate history taking, and inconsistent diagnostic criteria are key elements to its being underreported. […] Based on our evaluation, including an in-depth and accurate history provided by the patient and normal results of a 3-item recall memory test, we did not believe he had dementia and were concerned about visual impairment causing the perceived cognitive dysfunction. We made a preliminary diagnosis of CBS. […] While there are no formal diagnostic criteria, most clinicians agree on several core components: the presence of formed and complex hallucinations; full or partial retention of insight; absence of delusions; absence of hallucinations in other sensory modalities (eg, auditory or olfactory); and normal mental status.

• #31 Charles Bonnet Syndrome (CBS)

  https://www.enhancedvision.com/low-vision-info/eye-conditions/charles-bonnet-syndrome-cbs.html?srsltid=AfmBOoqkwY3pUVLPIHJYN4s3IaPrGbDMKizNgS14MjQ-GchsI18uZanl

  There are three main criteria for a diagnosis of CBS according to the authors of Charles Bonnet Syndrome; Visual Loss and Hallucinations CMAJ. 2009 August 4; 181(3-4): 175176. They are: […] 1. Visual Loss […] 2. Clearly formed recurrent visual hallucinations, and […] 3. Insight into the unreal nature of the hallucinations.

• #32 Charles Bonnet syndrome: forgotten but important – Pavilion Health Today

  https://pavilionhealthtoday.com/gm/charles-bonnet-syndrome-forgotten-but-important/

  While Podolls criteria provide a host of conditions to be considered and excluded to arrive at the diagnosis of CBS, Gold and Rabins put emphasis on the nature of the hallucinations and the preservation of insight. […] There has been no systematic research to uncover the neuroanatomical or neuropsychological correlates of hallucinations in CBS. Most cases of CBS do not show gross or microscopic brain pathology. […] Treatment outcome with this syndrome is unclear from the literature. Prognosis varies with the nature of visual dysfunction. […] The correct diagnosis of this condition is of utmost importance considering the serious implications of alternative diagnoses.

• #33 Charles Bonnet syndrome: forgotten but important – Pavilion Health Today

  https://pavilionhealthtoday.com/gm/charles-bonnet-syndrome-forgotten-but-important/

  While Podolls criteria provide a host of conditions to be considered and excluded to arrive at the diagnosis of CBS, Gold and Rabins put emphasis on the nature of the hallucinations and the preservation of insight. […] There has been no systematic research to uncover the neuroanatomical or neuropsychological correlates of hallucinations in CBS. Most cases of CBS do not show gross or microscopic brain pathology. […] Treatment outcome with this syndrome is unclear from the literature. Prognosis varies with the nature of visual dysfunction. […] The correct diagnosis of this condition is of utmost importance considering the serious implications of alternative diagnoses.

• #34 Charles Bonnet Syndrome: Symptoms and Treatment | Doctor

  https://patient.info/doctor/charles-bonnet-syndrome-pro

  Diagnosing Charles Bonnet syndrome involves considering it in an older patient who has vivid, elaborate and often stereotyped visual hallucinations (eg, groups of people or children, faces, wild animals and panoramic countryside scenes). […] There are no universally accepted diagnostic criteria. […] Partial sight (eg, due to macular degeneration, cataract or glaucoma) is also a factor in diagnosing CBS. […] An ability to modify the image or make it disappear by closing their eyes is noted in the diagnosis. […] A normal cognitive status is required for diagnosis. […] Absence of organic disease, psychosis, impaired conscious level, dementia (particularly Lewy body dementia), intoxication, metabolic abnormalities, and focal neurological illness is necessary for a proper diagnosis. […] If CBS is suspected but the patient has not been diagnosed with an eye problem, assess vision using a Snellen chart. […] If the vision is abnormal, refer to an optometrist or the local eye unit for a complete ocular examination including dilated fundus check.

• #35 Visual release hallucinations – Wikipedia

  https://en.wikipedia.org/wiki/Visual_release_hallucinations

  Visual release hallucinations, also known as Charles Bonnet syndrome (CBS), are a type of psychophysical visual disturbance in which a person with partial or severe blindness experiences visual hallucinations. […] A variety of disciplines including optometry, ophthalmology, geriatric medicine, psychiatry, and neurology play a part in securing the diagnosis of CBS. […] Since CBS is not commonly recognized by all clinicians, it oftentimes goes misdiagnosed and identified as psychosis, delirium, or dementia. […] By focusing on the specific type of visual hallucination, one may find an accurate diagnosis. […] If a patient presents symptoms indicative of Charles Bonnet syndrome, basic laboratory examinations like metabolic panel and blood count tests, as well as neuroimaging, may aid in an accurate diagnosis.

• #36

  https://link.springer.com/article/10.1007/s10792-024-03298-0

  The requirement that at least one complex image occurs alongside other, simpler hallucinations might be a useful tool to make an accurate differential diagnosis. […] Visual hallucinations occurred more frequently during the day (46.2%) and in bright surroundings (46.2%). […] All patients experienced the hallucinations only with their eyes open. […] It has been observed in literature that many patients feel unwell because of their hallucinations, at least to some extent. […] Future studies should further address the effects of the residual visual field size on CBS. […] The management of CBS may benefit from encouraging patients to share their experiences and consult a physician.

• #37 SciELO Brazil – Charles Bonnet syndrome: characteristics of its visual hallucinations and differential diagnosis Charles Bonnet syndrome: characteristics of its visual hallucinations and differential diagnosis

  https://www.scielo.br/j/anp/a/39XtvZhdJ3vLngRSzP8P3Fq/?lang=en

  Objective: To present an eight-case serie of patients with Charles Bonnet syndrome (CBS). […] All patients were initially evaluated by an ophthalmologist and then submitted to a neurologic evaluation with exclusion of alternative psychiatric and neurologic diagnoses. […] A mean delay of 41.7 months occurred until diagnosis. […] Physicians who care for low vision patients should be aware of CBS and appropriately diagnose its hallucinations after exclusion of psychiatric and neurologic diseases. […] Patients were diagnosed with CBS based on the detection of a significant visual impairment combined with visual hallucinations considered unreal by the patient. […] Many etiologies need to be ruled out in order to confirm the diagnosis of CBS. […] A thorough report on prescription and illicit drugs must be taken as well as if the patient has stopped taking them and might be in a withdrawal syndrome.

• #38 Approach to the patient with visual hallucinations – UpToDate

  https://www.uptodate.com/contents/approach-to-the-patient-with-visual-hallucinations

  Visual hallucinations can result from a wide variety of underlying etiologies. […] Visual hallucinations associated with the Charles Bonnet syndrome (CBS) are discussed separately. […] Familiarity with the disorders associated with visual hallucinations is essential to providing the appropriate care. The history, accompanying symptoms, and clinical signs are important elements for determining the most likely cause. In certain patients, further investigation may be necessary before a definitive cause can be determined.

• #39 EyeRounds.org: Charles Bonnet Syndrome

  http://eyerounds.org/cases/302-Charles_Bonnet.htm

  Charles Bonnet Syndrome is largely a clinical diagnosis, and patients who experience visual hallucinations in the classic clinical context of low vision with good insight into their condition may not need diagnostic testing. […] A careful review of medication lists for pharmacologic agents known to cause visual hallucinations, such as digoxin, sildenafil, or anticholinergics is also advised. […] Generally, CBS can be distinguished from other causes by a lack of other neurologic deficits and the presence of known ocular disease. […] In the case that a patient presents with symptoms suggestive of CBS, but without known eye disease, a full ophthalmologic exam should be performed. […] CBS is under-recognized and underdiagnosed, and several groups have advocated for screening in order to identify affected patients. […] One simple approach recommends utilizing a combination of indirect and direct questioning in all patients with underlying vision loss. […] If the patient is not forthcoming about a history of hallucinations, a more direct line of questioning can then be used.

• #40 Who is the Mystery Man? Charles Bonnet Syndrome in the Setting of Age-Related Macular Degeneration

  https://www.heraldopenaccess.us/openaccess/who-is-the-mystery-man-charles-bonnet-syndrome-in-the-setting-of-age-related-macular-degeneration

  In the absence of other neurologic abnormalities, and in the setting of known ocular disease (macular degeneration), further diagnostic evaluation may not be required. […] CBS is distinguished from these entities by the absence of other neurologic deficits and by the presence of known ocular disease.

• #41 Charles Bonnet Syndrome (CBS) – Gene Vision

  https://gene.vision/charles-bonnet-syndrome-cbs/

  Charles Bonnet Syndrome (CBS) is characterised by visual hallucinations in people affected by sight loss from any cause, including inherited eye disorders. […] CBS is estimated to affect 0.4-30% of people with sight loss, though it is considered to be underreported due to patients’ fears of being categorised as mentally ill, and a relative lack of awareness amongst the medical profession. […] It is important to remember that CBS hallucinations only involve sight. If other senses (hearing, smelling, tasting or touching) are involved as well then it is not considered to be CBS. Patients with CBS are also aware that the visual hallucinations experienced are not real compared to hallucinations from other causes. […] This study provides evidence that CBS occurs in children and the whole multidisciplinary team must raise awareness by actively asking/informing patients or families about symptoms.

• #42 Visual release hallucinations – Wikipedia

  https://en.wikipedia.org/wiki/Visual_release_hallucinations

  Visual release hallucinations, also known as Charles Bonnet syndrome (CBS), are a type of psychophysical visual disturbance in which a person with partial or severe blindness experiences visual hallucinations. […] A variety of disciplines including optometry, ophthalmology, geriatric medicine, psychiatry, and neurology play a part in securing the diagnosis of CBS. […] Since CBS is not commonly recognized by all clinicians, it oftentimes goes misdiagnosed and identified as psychosis, delirium, or dementia. […] By focusing on the specific type of visual hallucination, one may find an accurate diagnosis. […] If a patient presents symptoms indicative of Charles Bonnet syndrome, basic laboratory examinations like metabolic panel and blood count tests, as well as neuroimaging, may aid in an accurate diagnosis.

• #43 Charles Bonnet Syndrome – Rare Awareness Rare Education

  https://rareportal.org.au/rare-disease/charles-bonnet-syndrome/

  Charles Bonnet syndrome (CBS) is a vision-related condition in which individuals see images that are not actually present (phantom images) due to decreasing or loss of vision. CBS is a distinct clinical condition, as recognised by the World Health Organization (WHO), and is not due to psychosis, dementia, or other neurodegenerative issues. It is important for health professionals to be aware of CBS and help individuals to understand that it is a vision-related condition and not a mental condition. […] There is no definitive diagnostic test for Charles Bonnet syndrome (CBS). CBS is known as a diagnosis of exclusion, which means that all other possible causes (such as medication side effects, electrolyte imbalance, neurological or psychiatric causes) need to be ruled out. […] Healthcare professionals involved in the diagnosis and treatment of Charles Bonnet syndrome may include general practitioners (GP), neurologists, psychiatrists, geriatricians and ophthalmologists. The need for different healthcare professionals may change over a person’s lifetime and extend beyond those listed here.

• #44 A low dose of risperidone resolved Charles Bonnet syndrome after an un | NDT

  https://www.dovepress.com/a-low-dose-of-risperidone-resolved-charles-bonnet-syndrome-after-an-un-peer-reviewed-fulltext-article-NDT

  Charles Bonnet syndrome (CBS) is a diagnosis of exclusion. Typical affected patients have impaired visual acuity, vivid recurring visual hallucinations, and no cognitive impairment. CBS is usually diagnosed in patients with significant loss of vision and no cognitive impairment. […] The diagnosis of typical CBS was made based on the presence of visual hallucinations with visual impairment in a cognitively normal patient without psychiatric illness. […] The diagnosis of CBS is one of exclusion. Affected patients should be evaluated to exclude organic brain disorders, dementia, substance abuse, schizophrenia, and mood disorders. Evaluation should include a complete history, physical examination, and mental state examination. A team approach including psychiatry, neurology, and ophthalmology is best used to diagnose CBS. […] Most patients require only reassurance. When possible, treatment of the underlying visual disorder might lead to reduction or disappearance of hallucinatory phenomena. In more severe and disturbing cases, pharmacological treatment is required.

• #45 A Man’s Visual Hallucinations: Charles Bonnet Syndrome, Not Dementia With Psychosis | Consultant360

  https://www.consultant360.com/articles/man-s-visual-hallucinations-charles-bonnet-syndrome-not-dementia-psychosis

  Timely and accurate diagnosis is confounded by this lack of formal criteria, by provider unawareness of the diagnosis, by patients reluctance to report hallucinations out of fear of a mental illness diagnosis, and by inadequate provider sensitivity and questioning techniques. […] This case illustrates the need for increased awareness among health care providers about this common geriatric syndrome that can lead to diminished quality of life, increased functional impairment, and increased morbidity.

• #46 Charles Bonnet syndrome: a condition of the visually impaired – Dhooge – Annals of Eye Science

  https://aes.amegroups.org/article/view/6863/html

  The systematic review and meta-analysis by Subhi et al. in this edition of AES shows that the prevalence of Charles Bonnet syndrome (CBS) in the low vision population is approximately one in five. […] Understanding the phenomenon of CBS by these patients can alleviate these problems, however, most CBS patients are reluctant to share their hallucinogenic experiences out of fear of being labelled mentally unstable. Conversely, clinicians do not routinely check for these symptoms, as a result, CBS is often overlooked in ophthalmic practice. […] The first step in addressing CBS is the recognition by ophthalmologists that this condition is highly prevalent in our patient population. […] We should therefore actively identify patients with visual hallucinations among all patients with moderate to severe visual impairment (visual acuity lower than 6/18, but higher than 3/60), regardless of the underlying diagnosis, be it ophthalmic or neurologic.

• #47 Hallucinations & Macular Degeneration: What is Charles Bonnet Syndrome?

  https://www.brightfocus.org/resource/hallucinations-macular-degeneration-what-is-charles-bonnet-syndrome/

  Learn about Charles Bonnet syndrome, which can cause visual hallucinations in people living with macular degeneration, glaucoma, or cataracts. […] One sensitive issue often confronting people with advanced macular degeneration, glaucoma, or cataracts is visual hallucinations, called Charles Bonnet syndrome. […] People with Charles Bonnet syndrome realize that the images they see are not real. […] In contrast, people with psychiatric illness may experience delusions in which they believe the hallucinations they see are real. […] There is a special form of visual hallucination which may go with deteriorating vision or blindness. […] You have Charles Bonnet syndrome. […] Something like 10 percent, as I said, of visually impaired people get these. […] But no more than one percent of the people acknowledge them, because they are afraid they will be seen as insane or something.

• #48 Charles Bonnet Syndrome: Symptoms, Causes and Treatment

  https://www.medicoverhospitals.in/diseases/charles-bonnet-syndrome/

  Charles Bonnet Syndrome (CBS) is a complex condition characterized by visual hallucinations in individuals with significant vision loss. […] Diagnosing CBS can be challenging due to the stigma associated with hallucinations. Patients may hesitate to report their symptoms for fear of being labeled as mentally ill. However, accurate diagnosis is crucial for effective management. […] A comprehensive clinical evaluation is essential. This includes a thorough medical history and an eye examination to determine the extent of vision loss. The clinician should also inquire about the nature of the hallucinations, their frequency, and the patient’s awareness of their unreality. […] It is important to differentiate CBS from other conditions that can cause hallucinations, such as neurological disorders, psychiatric conditions, or medication side effects. Neuroimaging and other diagnostic tests may be necessary to rule out these conditions. […] Diagnosed through clinical history, eye exams, and ruling out other causes of hallucinations such as dementia or psychiatric disorders.

• #49 Visual release hallucinations (Charles Bonnet syndrome) – UpToDate

  https://www.uptodate.com/contents/visual-release-hallucinations-charles-bonnet-syndrome

  The Charles Bonnet syndrome (CBS) refers to symptoms of visual hallucinations that occur in patients with visual acuity loss or visual field loss. These are often called release hallucinations, reflecting the most widely accepted theory of their pathogenesis. […] Published case reports suggest that the syndrome is not well recognized by clinicians and may often be misdiagnosed as psychosis or early dementia. […] The pathophysiology, causes, clinical features, diagnosis, and treatment of the CBS will be reviewed here. […] When this symptom is specifically solicited in older patients with impaired vision, 11 to 15 percent admit to having visual hallucinations. […] One study found that only 12 percent of patients attending a retinal clinic were aware of the condition. […] Patients with more significant vision loss may be more likely to experience and report visual hallucinations.

• #50 SciELO Brazil – Charles Bonnet syndrome: characteristics of its visual hallucinations and differential diagnosis Charles Bonnet syndrome: characteristics of its visual hallucinations and differential diagnosis

  https://www.scielo.br/j/anp/a/39XtvZhdJ3vLngRSzP8P3Fq/?lang=en

  Objective: To present an eight-case serie of patients with Charles Bonnet syndrome (CBS). […] All patients were initially evaluated by an ophthalmologist and then submitted to a neurologic evaluation with exclusion of alternative psychiatric and neurologic diagnoses. […] A mean delay of 41.7 months occurred until diagnosis. […] Physicians who care for low vision patients should be aware of CBS and appropriately diagnose its hallucinations after exclusion of psychiatric and neurologic diseases. […] Patients were diagnosed with CBS based on the detection of a significant visual impairment combined with visual hallucinations considered unreal by the patient. […] Many etiologies need to be ruled out in order to confirm the diagnosis of CBS. […] A thorough report on prescription and illicit drugs must be taken as well as if the patient has stopped taking them and might be in a withdrawal syndrome.

• #51 Charles Bonnet Syndrome (CBS) | Sight Research UK

  https://www.sightresearchuk.org/conditions/charles-bonnet-syndrome/

  Awareness of CBS is growing but, currently, too few healthcare professionals have heard of the condition and mis-diagnosis can occur. […] Most people with diminishing sight receive no warning about CBS from their ophthalmologist or optometrist, which can cause them significant distress when they start to experience hallucinations as a result of their sight loss. […] GPs should be contacted if any type of hallucination develops. The vivid, visual hallucinations caused by CBS are completely silent and no other sense is involved. If there are no other signs of dementia or mental illness, the diagnosis is most likely CBS. By contrast, if the hallucinations are accompanied by sound, taste, smell, or touch, hallucinations are being caused by another reason. […] As yet, there is no specific test for CBS so, sometimes, tests will be carried out to establish definitely that no other condition such as dementia is present. […] Diagnosis of CBS can be made by the GP, with help from an ophthalmologist, optometrist, neurologist, psychiatrist, eye clinic liaison officer or rehabilitation officer for the visually impaired.

• #52 Charles Bonnet Syndrome – EyeWiki

  https://eyewiki.org/Charles_Bonnet_Syndrome

  Charles Bonnet Syndrome (CBS), named after the Swiss scientist who first described visual hallucinations in his grandfather in the 1970s, has three features: hallucinations, ocular pathology, and intact cognition. […] There is no standardized diagnostic criteria for CBS. One systematic review of 33 studies found that visual loss and the presence of formed or complex hallucinations were commonly included as key features. However, there is no consensus on other factors, including the severity of vision loss or the exclusion of confounding conditions or cognitive impairment. For example, CBS has been associated with dementia, but it is unclear if this is a confounder or a true association. As such, physicians should consider further screening for dementia or cognitive impairment in those with CBS symptoms.

• #53 Charles Bonnet syndrome: a condition of the visually impaired – Dhooge – Annals of Eye Science

  https://aes.amegroups.org/article/view/6863/html

  The systematic review and meta-analysis by Subhi et al. in this edition of AES shows that the prevalence of Charles Bonnet syndrome (CBS) in the low vision population is approximately one in five. […] Understanding the phenomenon of CBS by these patients can alleviate these problems, however, most CBS patients are reluctant to share their hallucinogenic experiences out of fear of being labelled mentally unstable. Conversely, clinicians do not routinely check for these symptoms, as a result, CBS is often overlooked in ophthalmic practice. […] The first step in addressing CBS is the recognition by ophthalmologists that this condition is highly prevalent in our patient population. […] We should therefore actively identify patients with visual hallucinations among all patients with moderate to severe visual impairment (visual acuity lower than 6/18, but higher than 3/60), regardless of the underlying diagnosis, be it ophthalmic or neurologic.

• #54 Charles Bonnet Syndrome – StatPearls – NCBI BookshelfTwitterFacebookLinkedInGitHubNCBI Insights BlogTwitterFacebookYoutube

  https://www.ncbi.nlm.nih.gov/books/NBK585133/

  Charles Bonnet syndrome (CBS) is a medical condition in which complex visual hallucinations occur concurrently with visual changes, specifically visual field loss or visual acuity loss. […] CBS often goes unrecognized and misdiagnosed with early dementia or psychosis. […] A detailed and systemic history is essential to rule out the existence of hallucinations. […] Upon ruling out hallucinations secondary to an underlying neurological condition or medication, the next step is confirming the presence of vision impairment or loss through a thorough ophthalmologic evaluation with visual field testing. […] In summary, a diagnosis of CBS can be made in individuals having only visual hallucinations in the absence of neurologic abnormalities while in the presence of known vision impairment or loss.

• #55 Visual release hallucinations (Charles Bonnet syndrome) – UpToDate

  https://www.uptodate.com/contents/visual-release-hallucinations-charles-bonnet-syndrome

  The Charles Bonnet syndrome (CBS) refers to symptoms of visual hallucinations that occur in patients with visual acuity loss or visual field loss. These are often called release hallucinations, reflecting the most widely accepted theory of their pathogenesis. […] Published case reports suggest that the syndrome is not well recognized by clinicians and may often be misdiagnosed as psychosis or early dementia. […] The pathophysiology, causes, clinical features, diagnosis, and treatment of the CBS will be reviewed here. […] When this symptom is specifically solicited in older patients with impaired vision, 11 to 15 percent admit to having visual hallucinations. […] One study found that only 12 percent of patients attending a retinal clinic were aware of the condition. […] Patients with more significant vision loss may be more likely to experience and report visual hallucinations.

• #56 A Case Report and Review: Charles Bonnet Syndrome Plus With Dementia

  https://scholarlycommons.hcahealthcare.com/hcahealthcarejournal/vol3/iss1/4/

  Charles Bonnet Syndrome (CBS) refers to visual hallucinations in visually impaired patients without psychiatric illness who are typically aware that their hallucinations are not real. […] Unfortunately, the clinical criteria for atypical CBS are ambiguous, potentially explaining the rarity of the diagnosis. […] Clearer guidelines for the diagnosis of atypical CBS and greater attention to the disorder could substantially improve the management of patients presenting with hallucinations. A broader differential diagnosis including atypical CBS for elderly patients with new-onset hallucinations could help clinicians and patients avoid unnecessary medical workup and treatment.

• #57 Charles Bonnet Syndrome: what is it and what help is out there? | Glaucoma UK

  https://glaucoma.uk/blog-category-blog/charles-bonnet-syndrome-what-is-it-and-what-help-is-out-there/

  Have you ever come across Charles Bonnet Syndrome (CBS) in your favourite TV show? […] Most importantly of all, CBS is not a mental health issue. […] It was shocking to hear how many people had been mis-diagnosed and ushered down the mental health pathway, wasting precious NHS resources and causing even more distress. […] Now, I am urging the NHS to create a pathway for diagnosis and treatment – with multi-disciplinary clinics so that CBS can be diagnosed correctly and swiftly.

• #58 Charles Bonnet syndrome: forgotten but important – Pavilion Health Today

  https://pavilionhealthtoday.com/gm/charles-bonnet-syndrome-forgotten-but-important/

  Charles Bonnet syndrome (CBS) is characterised by complex visual hallucinations generally against the background of visual impairment and in the absence of a neuropsychiatric disorder. […] CBS is a less frequently diagnosed despite it being a common cause of such hallucinations. […] Universal diagnostic criteria for CBS has not yet been established. Hence, there has been disagreement over its exact diagnostic criteria since CBS does not fit exactly into current classification systems. […] The nearest ICD 10 diagnosis would be organic hallucinosis. In this condition, the clinical picture is dominated by persistent or recurrent hallucinations, usually visual or auditory, occurring in clear consciousness and insight may be preserved. […] In the absence of universal consensus, the diagnostic criteria set forth by Podoll, and by Gold and Rabins, are widely accepted.

• #59 Negative outcome Charles Bonnet Syndrome | British Journal of Ophthalmology

  https://bjo.bmj.com/content/98/9/1236

  The 32% prevalence of negative outcome in our sample is similar to that described in previous studies. […] Some of the factors associated with negative outcome were linked to the hallucinations themselves (eg, how long a typical hallucination lasts and whether it induced fear) while others related to knowledge of CBS and quality of information. […] It is clear that CBS can no longer be considered a homogeneous, transient condition. […] This changes CBS from a symptom that can be largely ignored by clinical services to one that needs further characterisation to identify those with negative outcome and offer appropriate interventions. […] The findings also suggest negative outcome might be preventable, and the need for trials to examine the effectiveness of information/psychoeducation prior to the onset of hallucinations.

• #60 Challenges of diagnosing and treating Charles Bonnet syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6105053/

  Consider Charles Bonnet syndrome in patients with optical hallucinations after occipital stroke. […] Charles Bonnet syndrome (CBS) is primarily diagnosed in patients with an ophthalmic disease but is also seen in stroke patients with hemianopsia. […] To date, no universally accepted diagnostic criteria for CBS exist. Most of the proposed diagnostic criteria require formed visual hallucinations in the psychologically normal elderly patient. […] Even though largely unrecognized in the daily hospital routine, CBS should be considered as a diagnosis of hallucinating patients in whom other causes of visual hallucinations were excluded. […] A mainstay of treatment is the reassurance of patients that these visual hallucinations are inherently benign and not a sign of a psychiatric disorder. […] However, the effectiveness of melperone on hallucinations has to be proved further in a larger cohort of patients with CBS.

• #61 Charles Bonnet Syndrome: What Nurses Need to Know

  https://rn-journal.com/journal-of-nursing/charles-bonnet-syndrome-in-nursing-practice

  All nurses know the importance of an accurate history in ensuring that patients receive the proper diagnosis and treatment. […] Charles Bonnet Syndrome (CBS) is the name given to such hallucinations. […] Currently, Charles Bonnet Syndrome is the term used to describes the presence of visual hallucinations in people with no known mental illness but have significant vision loss. […] Nurses need to be aware that visual hallucinations are not necessarily indicative of psychiatric symptoms. […] CBS etiology should be ruled out before assuming visual hallucinations have a psychiatric etiology. […] Patients report relief when the hallucinations are explained as normal occurrences not of psychiatric origin. […] A complete and thorough history should include questions about hallucinations in the visually impaired elderly. This will help ensure proper treatment of CBS and also ensure proper patient evaluation in the future.

• #62 A Man’s Visual Hallucinations: Charles Bonnet Syndrome, Not Dementia With Psychosis | Consultant360

  https://www.consultant360.com/articles/man-s-visual-hallucinations-charles-bonnet-syndrome-not-dementia-psychosis

  Timely and accurate diagnosis is confounded by this lack of formal criteria, by provider unawareness of the diagnosis, by patients reluctance to report hallucinations out of fear of a mental illness diagnosis, and by inadequate provider sensitivity and questioning techniques. […] This case illustrates the need for increased awareness among health care providers about this common geriatric syndrome that can lead to diminished quality of life, increased functional impairment, and increased morbidity.

• #63 Negative outcome Charles Bonnet Syndrome | British Journal of Ophthalmology

  https://bjo.bmj.com/content/98/9/1236

  The 32% prevalence of negative outcome in our sample is similar to that described in previous studies. […] Some of the factors associated with negative outcome were linked to the hallucinations themselves (eg, how long a typical hallucination lasts and whether it induced fear) while others related to knowledge of CBS and quality of information. […] It is clear that CBS can no longer be considered a homogeneous, transient condition. […] This changes CBS from a symptom that can be largely ignored by clinical services to one that needs further characterisation to identify those with negative outcome and offer appropriate interventions. […] The findings also suggest negative outcome might be preventable, and the need for trials to examine the effectiveness of information/psychoeducation prior to the onset of hallucinations.

• #64 A Simple Guide to Charles Bonnet Syndrome, Diagnosis, Treatment and Related Conditions by Kenneth Kee | eBook | Barnes & Noble®

  https://www.barnesandnoble.com/w/a-simple-guide-to-charles-bonnet-syndrome-diagnosis-treatment-and-related-conditions-kenneth-kee/1143405520

  This book describes Charles Bonnet Syndrome (Visual Release Hallucinations), Diagnosis and Treatment and Related Diseases. […] Charles Bonnet Syndrome (CBS) is a disorder in which a person with partial or complete vision loss (partial or total blindness) develops complex visual hallucinations. […] The person might be diagnosed with Charles Bonnet syndrome if the person has: Vision impairment, Complex visual hallucination or phantom images recently, Known what the person saw was not real (i.e., no delusions), Knowledge that the person is not mentally ill, No noticeable issues with thinking or memory, Not have hallucinations involving other senses, such as the hearing. […] There is no known curative treatment for Charles Bonnet syndrome. […] The treatment measures for Charles Bonnet Syndrome may involve: Treating the underlying cause of vision loss such as age-related macular degeneration, cataract, glaucoma, etc., Vision aids to improve existing vision, Providing patient reassurance and emotional support, Administration of anti-epileptic or anti-anxiety medications, as needed. […] The restoration of vision has been shown to reduce or eliminate the visual hallucinations from Charles Bonnet Syndrome, in some cases.

• #65 Charles Bonnet Syndrome and Visual Hallucinations – Eye Doctor, Eye Care in Northeast Texas, Louisiana, and Arkansas

  https://www.familyeyecareclinic.net/blog/643-charles-bonnet-syndrome-and-visual-hallucinations

  Charles Bonnet Syndrome is now the term used to describe simple or complex hallucinations in people who have impaired vision. […] The prevalence of Charles Bonnet Syndrome among adults 65 years and older with significant vision loss is reported to be between 10% and 40%. […] If there is a reversible cause of decreased vision, such as significant cataract, then once the decreased vision is treated, the hallucinations should stop. […] If you experience any of these symptoms, please get evaluated by your eye doctor to make sure there is not a treatable eye condition.

• #66 The Ophthalmologist’s Map to Charles Bonnet Syndrome

  https://eyesoneyecare.com/resources/ophthalmologists-map-to-charles-bonnet-syndrome/

  Discover strategies ophthalmologists can employ to manage Charles Bonnet syndrome, which causes visual hallucinations in patients with significant vision loss. […] Charles Bonnet syndrome (CBS) is a phenomenon in which an individual with poor vision begins to see images that do not exist—visual hallucinations. […] Patients diagnosed with Charles Bonnet syndrome have variable and stereotypical presentations. […] The diagnosis code for Charles Bonnet syndrome would fall under „psychophysical visual disturbances.” The ICD-10 code to support this diagnosis is H53.16.8, and while there is no definitive treatment for CBS, there are existing treatment strategies. […] Patients with CBS recognize that the images they see are not real, even though they are very vivid. […] The best recommendation to rule out any psychiatric illness or related disease is to first speak with the patient’s primary care provider (PCP). If no diagnosis is made with the PCP, then CBS could be very likely.

• #67 Charles Bonnet syndrome: forgotten but important – Pavilion Health Today

  https://pavilionhealthtoday.com/gm/charles-bonnet-syndrome-forgotten-but-important/

  Charles Bonnet syndrome (CBS) is characterised by complex visual hallucinations generally against the background of visual impairment and in the absence of a neuropsychiatric disorder. […] CBS is a less frequently diagnosed despite it being a common cause of such hallucinations. […] Universal diagnostic criteria for CBS has not yet been established. Hence, there has been disagreement over its exact diagnostic criteria since CBS does not fit exactly into current classification systems. […] The nearest ICD 10 diagnosis would be organic hallucinosis. In this condition, the clinical picture is dominated by persistent or recurrent hallucinations, usually visual or auditory, occurring in clear consciousness and insight may be preserved. […] In the absence of universal consensus, the diagnostic criteria set forth by Podoll, and by Gold and Rabins, are widely accepted.

• #68 Charles Bonnet syndrome | healthdirect

  https://www.healthdirect.gov.au/charles-bonnet-syndrome

  Charles Bonnet syndrome is a condition where people have repeated visions. […] If you have Charles Bonnet syndrome, you do not have a mental illness. […] You might be diagnosed with Charles Bonnet syndrome if you: have recently seen visions, know what you saw was not real, are not mentally unwell. […] Diagnosing Charles Bonnet syndrome involves taking a full medical history and examining your eyes. It may also involve a physical examination and tests for other causes of your visions. […] Charles Bonnet syndrome is diagnosed by excluding other explanations for your visions.

• #69 Charles Bonnet Syndrome | Glaucoma Australia

  https://glaucoma.org.au/i-have-glaucoma/living-with-glaucoma/charles-bonnet-syndrome

  Up to one third of people with low vision may experience visual hallucinations […] Diagnosis of Charles Bonnet Syndrome […] Formed visual hallucinations […] Some degree of vision loss […] Patient has insight into the unreal nature of the visual phenomena […] No other psychological or neurological diagnosis to explain the symptoms […] It is thought that nearly one third of people with low vision (of any cause) will develop Charles Bonnet Syndrome. In studies of glaucoma, it was found that nearly 1 in 4 (23%) glaucoma patients experienced this phenomenon. […] Most people are not frightened by the hallucinations themselves, but they are fearful of being diagnosed with a mental illness. Therefore, after some reassurance that there is no mental illness or dementia, patients with Charles Bonnet Syndrome generally do not need any specific treatment.

• #70 Charles Bonnet Syndrome: Symptoms, Causes, Treatment | Qwark

  https://qwarkhealth.com/conditions/charles-bonnet-syndrome

  Charles Bonnet Syndrome (CBS) is a medical condition that can cause visual hallucinations in people who have some degree of vision loss. […] Though there is no known cure for CBS, it is important to seek medical attention if you are experiencing symptoms to ensure an accurate diagnosis and to receive proper care. […] The diagnosis of Charles Bonnet Syndrome (CBS) is usually a clinical diagnosis based on symptoms that are described by the patient. However, tests may be used to rule out other possible causes of the symptoms, such as eye exams, blood tests, and brain imaging tests. […] CBS is typically diagnosed through an evaluation by a healthcare professional who specializes in eye disorders. The diagnostic process usually begins with a comprehensive eye exam, including visual acuity testing, examination of the retina and optic nerve, and visual field testing.

• #71 Charles Bonnet syndrome | Your Eye HealthFacebookYouTubeInstagramLinkedInPinterest

  https://www.guidedogs.org.uk/getting-support/information-and-advice/eye-conditions/charles-bonnet-syndrome/

  Charles Bonnet syndrome is a condition that causes visual hallucinations in people with sight loss and of a sound mind. […] It’s important to see your GP if you start to experience hallucinations. They’ll discuss your symptoms and help you get a diagnosis. […] A healthcare professional usually diagnoses Charles Bonnet syndrome after taking a complete medical history. If you start experiencing hallucinations, speak to your GP or ophthalmologist. […] To make a diagnosis, a doctor will: Ask about your medical history, including any eye conditions. Ask about your symptoms, including details of your hallucinations. Sometimes do tests such as neurological and memory tests to rule out other possible conditions that can cause hallucinations. […] If you experience hallucinations, see your GP as soon as possible. If you have an eye disease or condition that has led to visual loss, you may have Charles Bonnet syndrome. Your doctor will discuss your symptoms and want to rule out any other conditions.

• #72 Diagnosis and Treatment – Moorfields Private

  https://www.moorfields.nhs.uk/private/eye-conditions-and-treatments/charles-bonnet-syndrome/diagnosis-and-treatment

  There is no specific test for Charles Bonnet syndrome. It is diagnosed through taking a detailed medical history and ruling out other possible causes for the hallucinations such as dementia. […] In individuals who are severely affected by these hallucinations, they can be referred to a psychiatrist for further investigation and management.

• #73 Charles Bonnet Syndrome: Causes, Symptoms, and Treatment

  https://patient.info/eye-care/charles-bonnet-syndrome

  Charles Bonnet syndrome diagnosis involves considering CBS as a likely cause if you experience visual hallucinations. […] In order to make the diagnosis the doctor will talk about your medical history, perform an eye examination. Some neurological and memory tests may also be done. This is to rule out some other conditions which can also cause visual hallucinations. […] CBS has nothing whatsoever to do with dementia and is entirely due to loss of sight. […] The condition is believed to occur in 10-15% of all people with moderate visual loss and up to 60% of people with severe visual loss. […] There are no specific tests for CBS.

• #74 Focus on Charles Bonnet Syndrome

  https://info.yourdolphin.com/charles-bonnet-syndrome

  Charles Bonnet Syndrome (CBS) can affect people with different eye conditions, such as age-related macular degeneration, glaucoma, or diabetic retinopathy. […] Diagnosing Charles Bonnet Syndrome (CBS) usually involves ruling out other possible causes of visual hallucinations, such as medication side effects, mental illness, or neurological conditions. […] To diagnose CBS, a doctor will typically conduct a thorough medical history and physical exam, including an eye exam to assess the extent and type of visual impairment. […] A diagnosis of Charles Bonnet Syndrome is typically made when a person has visual hallucinations that are not caused by any other medical or mental health condition, and they have significant vision loss or blindness due to an eye condition. […] Therefore, doctors may need to be proactive in asking about visual hallucinations and creating a safe and non-judgmental environment for patients to discuss their symptoms.

• #75 Negative outcome Charles Bonnet Syndrome | British Journal of Ophthalmology

  https://bjo.bmj.com/content/98/9/1236

  Charles Bonnet Syndrome (CBS) is widely considered a transient condition without adverse consequence, questioning the need for treatment. […] Here, we attempt to better understand negative outcome CBS and the factors that influence it. […] 492 people with CBS were identified. […] Factors associated with negative outcome were: (1) frequent, fear-inducing, longer-lasting hallucination episodes, (2) one or more daily activities affected, (3) attribution of hallucinations to serious mental illness, (4) not knowing about CBS at the onset of symptoms. […] CBS is of longer duration than previously suspected with clinically relevant consequences in a third of those affected. […] Interventions that reduce the frequency, duration or fear of individual hallucination episodes and education prior to hallucination onset may help reduce negative outcome.

• #76 Negative outcome Charles Bonnet Syndrome | British Journal of Ophthalmology

  https://bjo.bmj.com/content/98/9/1236

  The 32% prevalence of negative outcome in our sample is similar to that described in previous studies. […] Some of the factors associated with negative outcome were linked to the hallucinations themselves (eg, how long a typical hallucination lasts and whether it induced fear) while others related to knowledge of CBS and quality of information. […] It is clear that CBS can no longer be considered a homogeneous, transient condition. […] This changes CBS from a symptom that can be largely ignored by clinical services to one that needs further characterisation to identify those with negative outcome and offer appropriate interventions. […] The findings also suggest negative outcome might be preventable, and the need for trials to examine the effectiveness of information/psychoeducation prior to the onset of hallucinations.

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