Postoperative Hallucinations or Reality: Can Patients Differentiate Between Hallucinations and Reality?

Delirium is the most common psychiatric complication after surgery and is known to be a source of distress for patients. During the course of postoperative delirium, patients may experience hallucinations and can sometimes confuse these hallucinations with reality. We present a patient who experienced vivid hallucinations in the ICU after surgery that were indistinguishable from reality. The patient, a woman in her 20s, was admitted to the ICU after surgery and was confused because she felt that other patients had made sexual comments to her. However, the patient was able to recognize them as hallucinations because, despite her extreme myopia, she could clearly see her surroundings. A detailed examination of the medical records allowed the medical team to also determine that they were hallucinations. Healthcare professionals should be aware that patients may experience hallucinations that are indistinguishable from reality.