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  • Writer's pictureAnustup Kundu

The Risk To The Older Population : The Charles Bonnet Syndrome

News Desk, News Nation 360 : Visual hallucinations may be a common presentation in psychiatry. However, there is a fascinating neuro-ophthalmological condition in which a person with visual impairments may be psychologically normal and yet see objects, people, or shadows vividly. Dr Ruby Misra, Consultant of Disha Eye Hospitals has discussed about this. Patients with Charles Bonnet Syndrome, also known as "Phantom Vision," experience visual hallucinations as a result of damage to their visual pathway. The individual is cognizant and aware that the hallucinations are not real. Charles Bonnet, whose grandfather had low vision and was ninety years old, first reported experiencing the syndrome's visual hallucinations in 1760. Furthermore, a report claims that the idea of CBS is no longer unusual. According to research, the prevalence of CBS is 0.5% (5/1000) in the general population, 0.8% (1/120) in people with low visual acuity, 0.6% (2/346) in the elderly, and 0.8% (1/120) in both these groups. 39% of individuals with Macular Disease report experiencing visual hallucinations, compared to 20% of Glaucoma patients undergoing visual rehabilitation. Because of a lack of knowledge and a fear of being classified as mentally ill, CBS may go unreported. In a study, one-third of medical professionals were unsure or ignorant of the condition, while 47% of patients reported having hallucinations. The main theory explaining the occurrence of CBS is called the "Deafferentation Theory," which postulates that decreased sensory input in the eye causes increased activity in the occipital cortex, which in turn causes hallucinations. Macular degeneration, glaucoma, cataracts, retinitis pigmentosa, cerebral infarctions, diabetic retinopathy, and venous occlusion are among the common aetiologies. The range for CBS prevalence is 6.7% to 8.1%. Simple photopsia, branching forms, and grid-like patterns can all be common hallucinations, as can more intricate visions of people, cars, and tiny objects. They could linger several days or even hours. Regarding the growing prevalence of Charles Bonnet Syndrome, it is a very uncommon but dangerous visual impairment. They treated about two cases in the Disha Eye Hospitals Branch last year. Additionally, only two to three patients may be admitted each year. Yes, it's a relatively small number. The elderly generation's unwillingness and lack of awareness are the main cause of this. They are quite optimistic that the overall number of cases will increase if an appropriate line of communication is established with elderly patients suffering from age-related macular degeneration. Regretfully, there isn't a permanent cure for CBS. The two main components of management are patient education and counselling. Assuring the patient that the illness is benign and is a reaction to vision loss may help to lessen their suffering and anxiety. Rapid eye blinking, better lighting, changing rooms, turning on the TV or radio, practising meditation and other relaxation techniques are some strategies to lessen hallucinations. For certain patients, social interaction has improved, visual rehabilitation has helped, and psychiatric drugs like Olanzapine and Pregabalin have helped. Therefore, understanding the CBS disease process is crucial for the appropriate care of these patients. The ophthalmologist has a crucial role to play since prompt identification of the symptoms and indicators will lessen the patient's suffering and avoid misdiagnosis and needless mental health procedures.

Pic - Courtesy


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