Visual Hallucinations: referral to the eye clinic or psychiatric unit?

Farihah Tariq, Aman Harghandewal, Thomas MacEwan

Abstract

Visual hallucinations (VH) in people with deteriorating vision, who are otherwise healthy is known as Charles Bonnet syndrome (CBS) or ‘phantom eye syndrome’. Relative lack of awareness of this condition amongst clinicians, often coupled with patients being unwilling to divulge that they are experiencing hallucinations means the condition is under recognised. The diagnosis is usually one of exclusion, made once medical, neuro-psychiatric, or drug-induced conditions have been discounted. This report describes the case of a partially sighted 74 year old lady, with bilateral dry age-related macular degeneration and cataracts, but otherwise cognitively intact reporting having visual hallucinations. Early consideration, reassurance and patient education is key in the management of this benign yet distressing condition.

Keywords: charles bonnet syndrome, hallucinations, visual impairment