Case Report: Glaucoma Inducing Visual Hallucinations and Psychotherapy Intervention

Abstract

Introduction: Charles Bonnet Syndrome (CBS) has a high prevalence rate among individuals with Age-related Macular Degeneration (AMD), reaching 15.8% and affecting nearly one-third of AMD patients in vision rehabilitation centers. However, it rarely occurs in patients with glaucoma or cataracts, with a prevalence rate of approximately 2.8% and 2-6%, respectively. CBS is more common among the elderly, with an average age ranging between 70 and 85 years. The prevalence in patients with low vision issues is about 19.7%. Case Presentation: A 75-year-old male patient visited the psychiatric outpatient clinic complaining about seeing children, who were invisible to others. The patient was referred from an ophthalmology clinic and had been diagnosed with glaucoma. Visual hallucinations caused significant distress, and treatment consisted of sertraline 50 mg along with Cognitive Behavioral Therapy (CBT). Accordingly, there were signs of improvement after the 7th session of CBT. Conclusion: CBS often occurs in elderly patients who experience vision decline stemming from various eye diseases, specifically glaucoma. The rare nature and its low prevalence make diagnosis and the provision of appropriate therapy challenging. Proper therapy can reduce visual hallucinations, which potentially cause significant anxiety.