title: Seeing the unseen: Charles Bonnet syndrome revisited.
abstract: Charles Bonnet syndrome (CBS) is a rare condition that encompasses three clinical features: complex visual hallucinations, ocular pathology causing visual deterioration, and preserved cognitive status. Common associated ocular pathologies include age-related macular degeneration, glaucoma, and cataracts. Several theories have been proposed to try to explain the visual hallucinations. However, the pathophysiology remains poorly understood, and treatment is largely based on anecdotal data. The lack of awareness of CBS among medical professionals often leads to inappropriate diagnosis and medication. In a country like India, where awareness of mental health is not widespread, cultural myths and stigma prevent patients from seeking professional help. Here we describe two cases of CBS and revisit different ocular morbidities that have been reported to occur in conjunction with CBS. Psychiatrists and ophthalmologists alike must be sensitive to this clinical condition to ensure prompt diagnosis and treatment.
authors.affiliation: Disha Psychiatric Clinic, Mumbai, India.|National Burns Institute, Mumbai, India.
authors.forename: Aditya Gopinathan
authors.initials: AG
authors.lastname: Nair
authors.affiliation: Departments of Neuro-Ophthalmology, Ophthalmic Plastic Surgery and Ocular Oncology, Advanced Eye Hospital & Institute, Navi Mumbai, India.
authors.forename: Akshay Gopinathan
authors.initials: AG
authors.lastname: Nair
authors.affiliation: Disha Psychiatric Clinic, Mumbai, India.
authors.forename: Bharat R
authors.initials: BR
authors.lastname: Shah
authors.affiliation: Beyond Eye Care, Hyderabad, India.|Neuro-Ophthalmology Services, Centre for Sight, Hyderabad, India.
authors.forename: Rashmin Anilkumar
authors.initials: RA
authors.lastname: Gandhi
mesh_terms: D000368:Aged; D000588:Amines / Q000008:administration & dosage / Q000627:therapeutic use*; D001364:Awareness; D003509:Cyclohexanecarboxylic Acids / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D000077206:Gabapentin; D006212:Hallucinations / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008140:Lorazepam / Q000008:administration & dosage / Q000627:therapeutic use*; D008268:Macular Degeneration / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D008279:Magnetic Resonance Imaging; D008297:Male; D013577:Syndrome; D016896:Treatment Outcome; D014786:Vision Disorders / Q000188:drug therapy / Q000209:etiology / Q000523:psychology; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000588:Amines; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D008140:Lorazepam
keywords: Charles Bonnet syndrome; dementia; glaucoma; macular degeneration; visual hallucinations; visual impairment