Recognizing Charles Bonnet syndrome in the elderly.

Charles Bonnet syndrome (CBS) is an under-recognized and commonly misdiagnosed condition characterized by the presence of visual hallucinations that psychologically normal people acknowledge as being unreal. It is commonly associated with ocular pathology and usually observed in elderly individuals with visual impairment. The exact etiology of CBS is unknown; however, the presentation of hallucinations is believed to be a result of functional deterioration of the central and peripheral nervous systems. Eradication of hallucinations and recurrent episodes has been seen with the use of neuroleptic and anticonvulsant agents. Correction of underlying ocular disorders and low-vision rehabilitation may also help in the resolution of visions. Careful patient assessment is necessary to appropriately diagnose CBS and determine the best approach to management.