An examination of the relationship between low vision and Charles Bonnet syndrome

Can J Ophthalmol. 2009 Feb;44(1):49-52. doi: 10.3129/i08-169.


Objective: In recent years, the Low Vision Clinic (LVC) appeared to have a large percentage of patients admitting to phantom vision (Charles Bonnet syndrome [CBS]). The objective of this study was to learn more about CBS from an ophthalmological perspective, as research has been conducted primarily by other specialists.

Design: Large-scale prospective study using a cohort of low-vision and normal-vision subjects.

Participants: Two hundred fifty-eight low-vision and 251 control subjects (with little or no vision loss) were enrolled.

Methods: A comparison of visual acuity, ophthalmic conditions, eye treatments, medications, mental state, general health, socialization, etc., was undertaken, and other factors influencing the hallucinations were recorded.

Results: CBS was present in 34% of LVC subjects and in <2% of the general population with little or no vision loss. Many subjects had unformed hallucinations; bright lights or spot-like images should not be overlooked because they could be determined to be hallucinations upon further questioning of the patient. CBS occurred in subjects with visual acuity from 20/40 to 20/1600; subjects were twice as likely to have CBS if their visual acuity was between 20/301 and 20/800. The prevalence of CBS did not differ significantly by cause of visual problem. Thirty-four percent of people were distressed about their initial hallucination; many did not consult a doctor for an explanation, and if they did, many did not receive an adequate explanation.

Conclusions: This large-scale study shows that CBS is connected with a low vision level; thus, patients should be told about the common possibility of hallucinations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Hallucinations / physiopathology*
  • Hallucinations / psychology
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Syndrome
  • Vision, Binocular / physiology
  • Vision, Low / physiopathology*
  • Vision, Low / psychology
  • Visual Acuity / physiology