What are the signs and symptoms of Charles Bonnet syndrome?
Hallucinations associated with Charles Bonnet syndrome (CBS) can be simple, non-formed images such as lines, light flashes, or geometric shapes or they can be complex, formed images of people, animals, or scenes. They are usually not disturbing, and are typically only visual. Affected individuals typically have a loss of central visual acuity contributing to their symptoms, although this is not always the case. They are generally aware that the hallucinations are not real and do not have psychosis or dementia.
The timing and frequency of hallucinations can vary widely among individuals with CBS. They may be episodic, periodic, or chronic. The hallucinations are usually daily or weekly and tend to occur upon awakening. The duration of the hallucinations is usually several minutes, but can be seconds or hours. Typically, there is a distinctive pattern to the timing and frequency of the hallucinations for any given affected individual. The degree and complexity of the hallucinations also vary among individuals, but no association has been found between the complexity of the hallucinations and the severity of visual loss.
Associated symptoms depend upon the underlying disorder producing the visual loss. For example, strokes involving the visual pathways produce visual field loss and sometimes other neurologic deficits, while macular degeneration and diabetic retinopathy produce loss of visual acuity without neurologic deficits.
Last updated: 1/4/2013
Can individuals with Charles Bonnet syndrome have normal eye sight?
Charles Bonnet syndrome (CBS) has typically been described as always, or almost always, being associated with some form of visual impairment. Affected individuals often present with a wide variety of ocular conditions, with age-related macular degeneration being the most common. However, although there appears to be a clear association between vision loss and CBS, visual impairment is not necessarily an integral part of the syndrome - CBS has been reported to occur in individuals with no obvious ocular condition. Additionally, it is possible for an affected individual to have an abnormality in some part of the visual system that may not necessarily express itself as loss of visual acuity or visual impairment.
Last updated: 1/4/2013
We hope this information is helpful. We strongly recommend you discuss this information with your doctor. If you still have questions, please
Victoria S Pelak. Visual release hallucinations (Charles Bonnet syndrome). UpToDate. Waltham, MA: UpToDate; 2012;
Schadlu AP, Schadlu R, Shepherd JB 3rd. Charles Bonnet syndrome: a review. Curr Opin Ophthalmol. May 2009;
Vukicevic M, Fitzmaurice K. Butterflies and black lacy patterns: the prevalence and characteristics of Charles Bonnet hallucinations in an Australian population. Clin Experiment Ophthalmol. October 2008; 36(7):659-665.