What is Charles Bonnet Syndrome?
Charles Bonnet syndrome in the elderly is a condition in which an older adult with visual impairment sees things that are not real. In other words, they hallucinate. The prevalence of Charles Bonnet syndrome varies between 6.7% to 8.1% of the older adults with problems with their eyesight.
These hallucinations range from simple patterns to detailed and graphic images of events or people. They are visual and are not accompanied by other auditory or sensory hallucinations.
Charles Bonnet syndrome is caused only due to failing eyesight and not due to any mental condition or dementia. The older adult experiencing these hallucinations is usually aware that the visions are not real even though they seem clear and vivid.
In rare cases, older adults experience hallucinations with auditory inputs.
Why does Charles Bonnet Syndrome Occur?
There have been various studies conducted regarding Charles Bonnet Syndrome (CBS) even though there no definite diagnosis criteria. However, there are certain similarities in all the reported cases like an absence of control over the hallucination, occurrence of hallucination on closing the eyes or knowing (fully or partially) that the hallucination is not real.
The reason for the incidence of CBS is not clear. Some theories suggest that they occur due to neural damage to the visual pathway. In many ways, it is similar to a person “feeling” pain, itching or discomfort at an amputated site.
While visual impairment of any kind may cause CBS, it is more common in older adults with age-related macular degeneration or other diseases that affect central vision like cataract.
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CBS is not talked about openly because it has a certain stigma attached to it. Many people associate CBS with mental disorders. The prevalence of CBS in India is almost unknown. Only a few rare cases have been documented by psychiatrists in India.
CBS has no standard treatment method especially in cases of irreversible vision loss. However. Psychiatric medications along with educating, counselling and reassuring the older adult, and encouraging them to socialize more can be helpful in making the symptoms less severe.
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