Has this ever happened to you? You wake up in the middle of the night and see a strange man standing in the corner of your bedroom. You are scared silly. But then you realise it’s just your coat hanging on the hanger. You were simply imagining things as there wasn’t enough light for you. When you cannot see things clearly, your brain fill up the blanks.
In your half-awake state, your brain makes up for the lack of information and makes the coat look like a person. It’s fairly normal. But not when you see them quite often. Even when the light is apt and you are fully awake, you see things that don’t make sense. They are not even real. You might have low vision, any eye defect, or partial blindness that is making you hallucinate. Your low vision can be a cause of your hallucinations.
How does vision loss cause hallucinations?
Your brain makes up for the lack of information. Suppose you are reading a story. There’s not much information about the characters look or details, but the story is interesting. You start filling up the information and create an image of the character in your mind. You can visualise the scenes in the story when you read. Your brain is filling the blanks.
Similarly, when you look at things, your brain assumes things and give you information. When you can not see clearly, that is, your visual cells in the brain do not get enough information, the brain compensates for the lack of information and fills the gap with stored images in your memory.
When you get old, your vision falters, your brain helps you see things that aren’t clear by filling in your memories. It is the reason why you can see your spouse still beautiful in old age. Your brain fills in the image from your memory.
While the brain compensates for low vision, it is not always pleasant. You might see things that don’t make sense or can get scary too. You might start hallucinating strangers in your house or the things you see in horror movies playing out in front of your eyes. You might feel that you are losing your mind, but these symptoms can be an indicator of Charles Bonnet Syndrome.
What is Charles Bonnet Syndrome?
Charles Bonnet was an 18th-century philosophical writer, the first to notice this syndrome. His grandfather started hallucinating after getting cataracts. He would see birds, plants, patterns and things that were not there in front of him in reality.
Charles Bonnet syndrome is a syndrome when a pathologically normal person starts to hallucinate after suffering from significant vision loss. Their brain adjusts for the lack of visual information by adding in images from memory. So, is Charles Bonnet syndrome a neurological disorder? No. It is a syndrome that occurs after suffering significant vision loss and the brain’s adjustment to cope. It’s not a mental illness.
This syndrome affects one out of two people suffering from low vision. Most people affected by AMD suffer from visual hallucinations. And many times, they don’t realise they are hallucinating. When they realise they are hallucinating things, they do not consult in fear and embarrassment. They think they are suffering from a mental disease or progressing towards dementia.
Symptoms of Charles Bonnet Syndrome
Charles Bonnet Syndrome symptoms include significant vision loss, visual hallucinations, no control over hallucinations and a realisation that hallucinations aren’t real. The person suffering from it have difficulty performing everyday chores. The symptoms occur out of blue and can last for hours.
There are two types of visual hallucinations common in Charles Bonnet Syndrome -
- Simple; where you see patterns, lines, mosaics etc.
- Complicated; where you see people, buildings, objects. Usually, it happens to people with severe vision loss.
Charles Bonnet Syndrome differs from person to person and from episode to episode. Some of the features of CBS are -
- Black and white images
- Static images or moving images like a movie
- Seeing things bigger or smaller than normal
- Seeing fantastical images (mythical animals like dragons and unicorns) or realistic images
- Meaningless and random images; seeing familiar places or familiar faces
- Lasting for a brief time or long hours
- Nightmarish images; like horror movies or like a pleasant dream
What Causes Charles Bonnet Syndrome?
What is the most probable cause for the hallucinations of Charles Bonnet syndrome? It is because of vision loss and how the brain interprets the lack of information.
Vision loss because of cataracts, AMD, injuries or any other eye disease can lead to Charles Bonnet Syndrome. However, not every hallucination is a result of CBS or vision loss. There can be other reasons for visual hallucinations like dementia, stroke, mental illness, Parkinson’s disease, psychotic drugs, pituitary tumour etc.
How is Charles Bonnet Syndrome diagnosed?
The diagnosis includes your medical history, eye exams, and several other medical tests to check if the visual hallucinations are not caused by other diseases. More than often, CBS can be misdiagnosed as dementia, delirium or psychosis. Because of this, most patients hesitate to notify or confide to anyone.
Treatment for Charles Bonnet syndrome
There is no cure for CBS. However, knowing that they are suffering from CBS and not some mental illness makes it easier for the patients to cope. It takes away a lot of stress and anxiety.
According to a study, 60 per cent of the people don’t feel that hallucinations impact their lives to a great extent, 33 per cent feel that hallucinations disrupt their regular lives and 7 per cent even find them pleasant.
CBS resolves after 12-18 months without treatment. However, if you feel the symptoms are severe, you should seek medical help. Talking to a medical advisor can be helpful.
You can go through vision therapy too. There are vision therapies to adjust for low vision and vision impairment. It includes modifying your surroundings to support your low vision. You will see fewer hallucinations because of this and also avoid accidentally hurting yourself.
When you feel you are hallucinating, try changing your posture to see clearly. If you are sitting, try standing. You can blink and squint your eyes to get the hallucinations away. You can shift your gaze to clear the false images.
Another method that you can try is by changing the things around you. Adjust furniture in a way that they don’t trigger your vivid imaginations. Use contrasting colours for your furniture to aid you in daily life. You can see things clearly because of the colours and can navigate around by yourself.
Take better care of your eyes. After ageing, your vision starts faltering. By taking proper care, wearing proper eyewear, you can protect your vision. Even if your vision has diminished a lot, causing you to suffer from CBS, you can wear glasses to clear up your vision. If prescription glasses don’t help, try blinking or changing your posture. You will be fine. Have a positive attitude, and you can go through this syndrome.