DEAR DR. GOTT: My mother is a healthy, active and fun-loving 88-year-old. She is a regular reader of your column and wanted to share with your readers a frightening experience she had last year.
I was visiting her when she looked me right in the eye and said “I’m not crazy,” and went on to say that she had been seeing people coming into her living room and standing by her chair. She described the onset of these episodes with seeing vivid wallpaper with bright colors and distinct swirl patterns. These occurrences would escalate to a group of people coming through the door dressed n bright, mismatched clothing but she could never make out their faces. I was naturally worried that she was having mental instabilities so I called my wife and described the symptoms. She promptly started searching the internet, looking up delusion in seniors and the prognosis was never good. However, when she looked up hallucinations in seniors the first item that came up was Charles Bonnet syndrome.
Discovered by Bonnet in 1760, the article described exactly the same symptoms that my mother had experienced. Only one of her three eye doctors had ever heard of it and they were all amazed. It is a temporary condition brought on by failing eye sight and is experienced by a large percent of people with deteriorating eye sight that simply don’t tell anyone out of fear. Could you please tell your readers more about this intriguing condition so that they don’t have to deal with the fear that my mother experienced before she found out what was happening to her?
DEAR READER: Charles Bonnet syndrome (CBS) is a temporary condition caused by serious partial vision loss that causes visual hallucinations. It is not caused by mental illness or dementia. It is thought that the hallucinations are the result of the brain trying to react to the loss. It typically lasts between 12 and 18 months, after which the brain begins to accommodate the new poorer vision. Research suggests that up to 60% of those with serious sight loss may develop CBS. Cataracts, glaucoma, diabetic eye disease, and age-related macular degeneration are known to be factors.
Sufferers commonly see two broad types of hallucinations. The first and most common, is simple and includes simple shapes, colored dots, simple but often repeating patterns, straight lines, or networks of branches. The second are complex and include highly detailed images of people, animals, insects, landscapes and buildings. In either instance, the image(s) may appear in vivid color and/or black and white. Both simple and complex visions can occur simultaneously or immediately following the other. In some instances, the hallucinations may appear real, blending with the background image, such as when looking at an empty field but seeing horses or cows. In other cases, the hallucinations are rather unbelievable, such as seeing fantastical creatures (dragons, elves, etc.).
Each episode can come on suddenly and last from several minutes to several hours. It is more common for these hallucinations to occur when the individual is alone, inactive, with no distractions, and in dim light. The false images are clearer than normal vision.
There is no cure and no proven effective treatment for Charles Bonnet syndrome. Often, the sufferer can best deal with the problem by recognizing that the images are not the result of mental deterioration and through learning coping mechanisms. In some instances they can be dispelled by simple techniques such as blinking rapidly, moving the eyes back and forth and up and down rapidly, looking or walking away from the hallucination, staring at or moving toward the vision, turning a light on or off, shutting the eyes briefly, or finding a distraction.
Therapy and counseling may be helpful, especially if the symptoms are confusing, disturbing or difficult to cope with. In these instances, medication may be recommended, but those drugs found to have some success are powerful and carry potentially serious complications and should only be used as a last resort. These drugs include anti-convulsants, Parkinson’s medications, and those used in the treatment of dementia and mental health issues.
Hallucinations are never normal and should always be taken seriously. No one is “crazy” just because they are seeing things that aren’t there and without testing, examination, and discussion, the sufferer will never know if treatment is available. In the case of Charles Bonnet syndrome, the brain is only throwing out abnormal images because the eyes are failing to take in adequate information.
