Forty-three patients with severe visual impairment due to bilateral eye disease were assessed for visual hallucinations, 28 of them after eye surgery. Ages ranged between 65 and 93 years and none of the patients had any psychiatric disorder. Five of the 43 patients were diagnosed as cases with Charles Bonnet syndrome reporting visual hallucinations that had developed in the course of sight deterioration. There was strong indication that sensory deprivation was an essential pathogenetic factor for this phenomenon. Three of the 28 patients assessed following eye surgery who had no history of hallucinatory phenomena experienced visual hallucinations on the 2nd postoperative day without showing any other psychiatric symptoms. The various conditions associated with visual hallucinations are discussed that may be of relevance to the ophthalmologist.