National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Charles Bonnet syndrome


Other Names:
CBS
Categories:
Charles Bonnet syndrome (CBS) is a disease in which visual hallucinations occur as a result of vision loss. CBS is not thought to be related to psychosis or dementia and people with CBS are aware that their hallucinations are not real.[1][2][3] The hallucinations people with CBS experience can be described as simple or complex. Simple hallucinations include shapes and patterns, while complex include images of people, vehicles, animals, and plants. Hallucination episodes can range from a few seconds to hours and may recur over the course of several days to years.[2] 

The cause of CBS is not well understood, but it is thought to be related to the brain continuing to interpret images, even in their absence.[4][3] There are many underlying diseases of vision loss that are associated with CBS, such as macular degeneration and stroke. Hallucinations may resolve in instances where the the underlying vision issue can be corrected (such as with cataracts). Treatment differs depending on the impact symptoms have on a person's life. Some people are taught to block their hallucinations, while others may benefit from antipsychotic medications.[1]
Last updated: 3/30/2018
Hallucinations associated with Charles Bonnet syndrome (CBS) can be simple, non-formed images such as lines, light flashes, patterns, or geometric shapes. They also can be complex, such as images of people, animals, or scenes. They are usually not disturbing and do not involve other senses. People with CBS are generally aware that the hallucinations are not real and do not have an underlying psychological disease or dementia.[1][2]

The timing and frequency of hallucinations can vary widely. The hallucinations tend to occur upon awakening. They usually last several minutes, but can be seconds or hours. Typically, there is a distinctive pattern to the timing and frequency of the hallucinations. The degree and complexity of the hallucinations also vary among individuals, but no association has been found between the complexity of the hallucinations and the severity of visual loss.[1][4][3]

Associated symptoms depend upon the underlying disorder producing the visual loss. For example, strokes involving the visual pathways produce vision loss and sometimes other neurologic deficits, while macular degeneration and diabetic retinopathy produce loss of vision loss without neurologic deficits.[1]
Last updated: 3/30/2018
While there is currently no single treatment that is effective for all cases of Charles Bonnet syndrome, there are steps that patients can take that might have a positive effect:[1][5]
  • Optimal eye care and regular visits to the ophthalmologist
  • Low vision aids to help maximize any existing vision
  • Avoidance of conditions known to aggravate CBS such as stress, anxiety, social isolation, and sensory deprivation
  • Reassurance that the hallucinated images are benign and that treatment is an option
  • Medications including olanzapine, quetiapine, carbamazepine, clonazepam, and donepezil
  • Certain rapid eye movements or blinking to help suppress the hallucination
  • Repetitive transcranial magnetic stimulation

The Charles Bonnet Syndrome Foundation has additional information.

Last updated: 3/30/2018

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

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These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • VisionAware is a support and information resource offered by the American Foundation for the Blind. They provide an information page on Charles Bonnet syndrome.

In-Depth Information

  • PubMed is a searchable database of medical literature and lists journal articles that discuss Charles Bonnet syndrome. Click on the link to view a sample search on this topic.

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know. Submit a new question

  • I was diagnosed with Charles Bonnet syndrome today with hallucinations in my right eye but I do not have any other problems with my eye sight. Are there people who just have the hallucinations? See answer


  1. Pelak VS. Visual release hallucinations (Charles Bonnet syndrome). UpToDate. Waltham, MA: UpToDate; June 7, 2016; https://www.uptodate.com/contents/visual-release-hallucinations-charles-bonnet-syndrome.
  2. Pang L. Hallucinations Experienced by Visually Impaired: Charles Bonnet Syndrome. Optom Vis Sci. December 2016; 93(12):1466-1476. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5131689.
  3. Duffy MA. Charles Bonnet Syndrome: Why Am I Having These Visual Hallucinations?. VisionAware. http://www.visionaware.org/info/your-eye-condition/guide-to-eye-conditions/charles-bonnet-syndrome/124. Accessed 3/30/2018.
  4. P. Ricard. Vision loss and visual hallucinations: the Charles Bonnet syndrome. Community Eye Health. March 2009; 22(69):14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2683559/.
  5. Treatments. Charles Bonnet Syndrome Foundation. http://www.charlesbonnetsyndrome.org/index.php/cbs/treatments. Accessed 1/26/2017.