Practice patterns in reporting and documentation of Charles Bonnet syndrome: a retrospective review following COVID-19.

BACKGROUND

Charles Bonnet syndrome (CBS) is characterized by visual hallucinations occurring in people with visual impairment. CBS can negatively impact psychological well-being, and the COVID-19 pandemic period was associated with an exacerbation of symptoms.

OBJECTIVES

To compare clinical practice patterns and reporting of CBS at a tertiary eye care center between an interval prior to the COVID-19 pandemic and an interval during the pandemic.

DESIGN

Retrospective chart review.

METHODS

A search of electronic medical records for all suspected CBS cases was conducted between 1 March 2019 and 29 February 2020 (prior pandemic interval) and between 1 September 2020 and 29 August 2021 (peri-pandemic interval). Data retrieved from records included patient demographics, visual acuity at the time of CBS onset, type of hallucinations, reporting healthcare professional, management strategies and patient-reported impact of hallucinations.

RESULTS

In total, 223 appointments referred to CBS in 156 patients at the prior interval, while 239 appointments referred to CBS in 155 patients at the peri-pandemic interval, representing 0.07% and 0.09% of all hospital attendance, respectively. Clinical subspecialty where CBS was most commonly reported was medical retina, and a greater proportion of patients at both time intervals were female. Types of hallucinations, management strategies and patient-reported impact were seldom reported, although documentation improved at the latter interval.

CONCLUSION

Practice patterns and patient characteristics were similar between the two intervals; however, subtle differences suggest a growing awareness of CBS. Targeted interventions in high-burden clinical subspecialties may encourage reporting and improve documentation of CBS.