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Vision Loss, Hallucinations, and Charles Bonnet Syndrome

The Charles Bonnet Syndrome is that visual hallucination event most commonly assumed to be the phenomenon experienced only by  those with low vision.

While the elderly are more likely to ex

Vladmir Kush art

perience CBS, there have been reported cases of children with CBS visual hallucinations. The problem with defining CBS is that individuals are not likely to report visual events for fear that they will be perceived as old and ‘losing it,’ or crazy and  in need of psychological help or medications.

Those who experience CBS hallucinations are those who:

  • have recent vision loss, not usually those with long term vision loss,
  • have lost the vision in both eyes, (20/100 or worse), and
  • are mentally alert, attentive, and understand the hallucinations are not real.

The elderly who experience eye diseases of old age most commonly experience CBS, especially those with age-related macular degeneration. CBS can occur for those with vision loss due to cataracts and diseases that affect the retina, such as  glaucoma, diabetic retinopathy, optic neuropathy, retinitis pigmentosa or any disease that causes vision loss due to damage along the visual pathway of the brain.

The hallucinations of Charles Bonnet Syndrome can be simple lines and patterns or complex with animals, people, scenery, and action. Sometimes they are cartoon like, small in size, or grotesque in appearance.  They are reported to be brilliant in imagery and blend into the surrounding  scenery. They may last a few fleeting seconds or may last for hours. These experiences are episodic and may continue for months to a year. They will eventually end. Those who have these visual experiences may find them disturbing, but do not usually describe them as horrifying or threatening. The images do not interact with them, they are merely observers. Studies indicate that those who live alone are more likely to experience the visual images of CBS.   The hallucinations may be triggered by sitting quietly or in bed when there is low light levels. It may also be related to fatigue or stress.

It is believed that visual hallucinations of the CBS are the result of the sudden vision loss due to  pathology somewhere along the visual system, which includes the eye, the neural connections, or the occipital cortex part of the brain at the back of the head. The visual hallucinations are analogous to the phantom pain experienced by an amputee. Phantom pain is pain felt in the area where the limb was before it was removed.  The brain is filling in the ‘blanks’ where there is no longer any stimulus. The eye doesn’t experience pain with vision loss, but experiences phantom vision. The nerves of the visual system are still firing, in the absence of stimulus, in the form of images. Hallucinations can be called phantom vision!

There are case reports of people, disturbed by the hallucinations, seeking medical help. There is no one direct treatment for these visual disturbances. Resolving the underlying condition of the vision loss will help, for example, cataract surgery for vision loss due to cataracts. Unfortunately, restoring vision is not usually possible.  Reports indicate people have used eye movement, eye closure, or lighting changes at the time to dispel the hallucination. Reducing isolation, vision rehabilitation, and the use of optical aids can help an individual redirect visual stimulation.

Co enzyme q10

Co q10 is a molecule of the ubiquinone family of compounds . The ubiquinones are substances that are found throughout the body, hence the term  “ubiquitous”. It is not considered a vitamin because it can be made by the body. Coenzyme q10 is found in cell membranes, where it has two functions: (1) it is an essential compound used by the cell to form energy in the form of ATP, from carbohydrates to be used by the cell,  (2) it is  involved in free radical scavenging. Continue reading Co enzyme q10

The Carotenoid: Astaxanthin

Astaxanthin is a nutrient of the carotenoid group. Previously, I discussed the carotenoids lutein and zeaxanthin. The carotenoids are important as a nutrient for their anti-oxidant capability to neutralize free radicals, made by the process of cellular metabolism, that have the potential to damage cells. This has important implications for those with eye disease, as a supplement to decrease cellular damage. Continue reading The Carotenoid: Astaxanthin


Crocus salivus, saffron flower
Crocus salivus, saffron flower

Saffron is the spice derived from the three stigmas (red colored threads about 25-30 mm long) of the crocus flower. Not the same crocus we grow here in the States, which blooms in the spring, but a crocus grown predominantly in the Middle East. This variety of crocus (Crocus sativus) blooms in the Fall. The world’s largest  producer of saffron is Iran. Because it takes thousands of flowers to produce an ounce of saffron, it is very expensive at about $30. USD an ounce. Continue reading Saffron

The Flavonoids, Bilberry

Bilberry is a small fruit berry found growing wild on scrubs in Europe. It is dark in color, purplish-blue and is similar to the blueberries found in the United States, but is actually more closely related to huckleberries. It is the dark purplish-blue color that is the active ingredient of bilberries, called anthocyanin.  Anthocyanin is one of the organic substances of the Flavoinoid class of antioxidants. Anti-oxidants react with damaging free radicals in our bodies to prevent or reverse cell damage that can lead to disease. These same substances are also found in berries such as raspberries, strawberries, cranberries, and sour cherries. Bilberry is notable for having the highest concentration of anthocyanin meaning it has powerful anti-oxidant capability. Continue reading The Flavonoids, Bilberry

Eye Vitamins: Turmeric and Curcumin

Turmeric is known as the “golden spice,” for its bright orange-yellow color. It is derived from an underground stalk, called a rhizome, of a tropical plant, much like ginger. It is one of the spices common to curry powder and is a staple in Indian cooking.  It has long been used for its medicinal properties in ancient Indian medicine because of its anti-oxidant, anti-inflammatory,  neuroprotective, and anti-cancer effects.  Curcumin is the active ingredient of turmeric. It is the curcumin which has the anti-oxidant and anti-inflammatory effect. The curcuminoids account for about 2 – 9% of turmeric. The spice is also a source of vitamin C and magnesium. Continue reading Eye Vitamins: Turmeric and Curcumin

Eye Vitamins: The Antioxidant Vitamin E

Vitamin E refers a group of fat soluble chemicals. While there are several forms, alpha- tocopherol is the form that the body recognizes as a nutrient. It is an important antioxidant to reduce the damage caused by free radicals and it is thought to help strengthen the immune system, blood, and cell membranes. Continue reading Eye Vitamins: The Antioxidant Vitamin E

Eye Vitamins: The Antioxidant, Vitamin C

While vitamin C is one of many antioxidants, it is a nutrient that is important to many biochemical reactions in the body and is essential for overall health and is considered to have an anti-aging effect.  It is an essential antioxidant which scavenges for those free radicals produced by the body’s metabolic activity and environmental  attacks to reduce oxidative stress. It is crucial for cardiovascular health, supports the immune system, and nerve cell function. Continue reading Eye Vitamins: The Antioxidant, Vitamin C


Antioxidant means: Anti– (from Latin) is “against,” “opposed to” and oxidant refers to reactive molecules produced during the body’s oxygen metabolism or created from environmental causes. Antioxidants, therefore, are those molecules responsible for reducing those reactive molecules which are free radicals and oxidants. Free radicals and oxidants have been implicated as one of the causes of disease. Continue reading Antioxidants