Charles Bonnet Syndrome – Treatment, Symptoms and Causes

What is Charles Bonnet Syndrome?

Charles Bonnet Syndrome is a condition that is seen in persons who have experience losing their visual senses because of cataract, diabetic eye disease, glaucoma, or age related macular degeneration. It makes them experience visual hallucinations, wherein they see things which are not really there in reality. They are reportedly seen on elderly persons having a bilateral decrease visual sense which experiences formed and vivid hallucination without any diagnosis of psychiatric disorder. However, there are also some report that it happens in children and sometimes this kind of syndrome are overlooked by some medical professional. The visual hallucinations which are found in the Charles Bonnet Syndrome indicate the segregation of the hierarchy of the visual pathways into streams. The visual hallucination creates images that are vivid and represents the releasing of hallucination due to the fact that they occur mostly upon the absence of the pathology of CNS or central nervous system. This kind of syndrome is benign, it will cease after the improvement of the person’s vision. Rest assured that the visual hallucinations occur temporarily.


  • The name behind the Charles Bonnet Syndrome was named after the person who has discovered such syndrome, who was Charles Bonnet himself way back 1760. He was a Swiss naturalist that defined the syndrome as it was experienced and manifested by his visually impaired grandfather who was around 89 years of age.
  • His grandfather was nearly blind because of he suffered cataracts in both of his eyes. He refer it to the similar state or condition one experiences in the phantom limb phenomenon.

Symptoms and Signs

In diagnosing persons with Charles Bonnet Syndrome, the following persons should manifest or experience the following symptoms and signs:

  1. Visual hallucinations which occurs periodically and sometimes may be very detailed and animated
  2. Visual impairment
  3. Partial intact eye vision
  4. Lack of evidence of any psychological disorder
  5. Senile dementia
  6. Normal cognitive status
Charles Bonnet syndrome visual changes

Characteristics and Causes

As we all know, the brain and the eyes are connected. The eyes see things and the brain processes the things that the eyes see which results to images that depict.

  • As the waning of the visual sense, the brain still functions normally but bizarrely as the brain tries to interpret the imagery produced by the visual sense without the visual input. Person who are stricken with this kind of syndrome, view the world as adorned with unreal yet vivid imagery.
  • They see nonexistent covered surfaces like tiles or brickwork and other are able to see delusional objects in confounding details that includes buildings, people, animals or whatever their brains could beseech.
  • The images were reported to linger for awhile, either appearing, vanishing or recurring in an abrupt manner. Images reported by persons having this syndrome were children dancing with a giant flower head and the like.

The exact causes of why such condition occurs in some individuals are up to the present still unidentified. However, the theory suggests that the brain compensates for the lack of visual stimulus. Another theory suggests that it is a result of similar mechanisms which generates our dreams. As like in the dreams, the mind lacks visual input during the period that we are sleeping. Hence, with this in mind, the mechanism is the same. What happens is that the visual cortex gratifies itself, due to the fact that it is bored because of no stimulation, with the use of imagery that was stored. Some experts would say that the cause of this syndrome is due to the fact that one experience old age or having damaged optical pathways or eyes, for that matter. It is also associated with poisoning because of methyl alcohol which will bring about this syndrome.

Persons at risk for this syndrome are those who are having problems or conditions such as:

  1. Macular degeneration
  2. Glaucoma
  3. Cataracts
  4. Persons who live alone
  5. Elderly persons (although some children are reported to have such condition)
  6. Normally Health individuals


In diagnosing such syndrome, it is proper that you consult the eye specialist and the neurologist. Since, as discussed, the culprit of why persons experience such syndrome is because they have visual problems. Also, neurologist has to be consulted to rule out other serious potential disorders which may imitate the symptoms associated with the Charles Bonnet Syndrome. Hence, the following important diagnostic test associated with this syndrome is as follows:

  1. Eye diagnostic examination
  2. Neurological diagnostic examination


With regards to the treatment for Charles Bonnet Syndrome, the physician usually don’t require treatment since, as mentioned awhile ago, this syndrome vanishes through time. Hence, it resolves by its own. The persons experiencing this syndrome would have to be told that this is not a mental illness. Some physician will suggest an interruption of visual activity by closing the eyes or blinking can be helpful in treating such disorder. However, some physician will require others to be treated with the following medications which are classified as:

  1. Anticonvulsants
  2. Atypical Antipsychotics
  3. Antidepressants


The prognosis of persons having Charles Bonnet Syndrome varies. For most of these persons, the symptoms that they experience or manifest will last only for about 18 months after and others experiences great improvement if the visual senses improves or it will be totally eradicated.


Persons who are experiencing or going through the Charles Bonnet Syndrome, may encounter the following complications that is associated with this kind of syndrome:

  1. Social isolation
  2. Anxiety
  3. Depression

They encounter such complications as they are having experiencing unreal imagery which makes them ashamed to socialize with others and hence, results to isolation. They are also anxious about the unusual visual images that they see. Lastly, they become depress as to the things they see may not be real and they feel detached as they no longer view the world normally because of their condition.

6 thoughts on “Charles Bonnet Syndrome – Treatment, Symptoms and Causes

  • 04/04/2014 at 9:37 AM

    Can a patient with CBS also have auditory hallucinations?

  • 08/09/2016 at 4:35 AM

    My husband sees and can play those cards everywhere he goes. He has been completely blind about 8 months ago. He started seeing the cards right away. He always played cards on the computer everyday before he went he lays down in his recliner and plays on the ceiling. He sees them everywhere. He pushes his hands up and down his body like the computer mouse and moves them and throws the discards in the thrash can..he knows that the cards are to therebut it keeps him entertained. Sometimes he gets frustrated when things don’t work out like he wants it. I have just recently found out about Charles Bonnet Syndrome..

  • 16/02/2017 at 4:39 AM

    My mother has been suffering with CBS for approximately one year. At times she finds it difficult to distinguish reality vs. her hallucinations needing family to confirm that it is her CBS. We are having difficulty finding others with CBS, support groups, and treatment options, especially when hallucinations keep her up all night (sleep deprivation makes it worse). Any suggestions for support, resources would be appreciated. She lives in CT.

    • 05/10/2017 at 8:23 PM

      Sharon- my step mother has the same thing…did you receive any advice on how to handle hallucinations keep her up all night (sleep deprivation makes it worse)?

      Sincerely ,

  • 16/10/2018 at 11:51 PM

    My mother lost her eyesight in 2015 due to a baby stroke on her optic nerve when she was 82, she was diagnosed with Charles Bonnet syndrome by the eye specialist, my mother sees wicker, paintings, soldiers on a train, children plus other hallucinations which can last all day. This morning she saw flashing lights, when mum doesn’t have CBS she sees black and sometimes gray, now and then the ceiling fan moving or me waving in front of her like a shadow

  • 29/03/2019 at 5:10 AM

    Has anyone tried using antidepressants? I would like to know if it helps.


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