I just wrote an article on my blog regarding visual hallucinations. Once in a while, patients that have become legally blind, or worse, may “complain” about randomly “seeing” images in perfect detail. Many times these patients are very concerned about losing their mind. The family, too, is concerned, fearing that dear old mom or dad is becoming demented. This is not necessarily true.

This may be a manifestation of the Charles Bonnet Syndrome (CBS). It usually affects patients that once could see well, but now are rendered with severe vision loss. In my experience, these are usually people with advanced macular degeneration.

CBS is not well understood. While I don’t know the exact cause, I liken these hallucinations to a type of visual sensory deprivation. The brain is smart and know it should “see” in much better detail than it does. It creates these images to provide sufficient “visual” stimuli. I also use the analogy of phantom pain in people suffering the loss of a limb.

CBS patients are usually completely oriented, coherent and intelligent. They present to the office fearful of going crazy. They are smart enough to know this doesn’t make sense. While there are many other reasons that may cause similar symptoms, there may be a plausible, happier explanation.

Randall V. Wong, M.D.
Retinal Specialist
http://www.TotalRetina.com