Charles Bonnet Syndrome with Atypical Features: Case Report

Abstract

Charles Bonnet syndrome (CBS) is a lesser-known condition characterized by recurring or persistent complex visual hallucinations (VHs) that emerge alongside a preceding decline in visual acuity. Individuals with CBS notably maintain their grasp on reality and possess an understanding of the fictitious nature of their VHs. However, due to a general lack of awareness within the medical community; CBS is often erroneously diagnosed as dementia or new-onset psychosis. This syndrome is linked to age-related macular degeneration, glaucoma, and cataracts. Diagnosing CBS hinges primarily on the patient’s medical history, clinical presentation, information from collateral sources, and a process of exclusion for other potential explanations. Unfortunately, no definitive cure exists for CBS, with treatment primarily centered on offering reassurance and education; nevertheless, persistent hallucinations containing unsettling imagery might require targeted intervention, employing offlabel use of psychotropic medications (such as antipsychotics, antidepressants, and anticonvulsants) to address refractory symptoms. This case report underscores a CBS instance with atypical features, highlighting the diagnostic and therapeutic approach applied to promote accurate identification and treatment.