Abstract
Purpose :
Charles Bonnet syndrome (CBS) is the phenomenon of visual hallucinations experienced by people living with sight loss. Despite the high prevalence, awareness among patients and professionals is generally low contributing to an underreporting of CBS. The aim of this study was to analyse clinical features and practice patterns of CBS and to explore military veterans' experiences of living with the condition.
Methods :
Retrospective review of medical records for patients presenting between two time intervals at a single hospital eye service in London, UK. Intervals were identified as pre-pandemic and peri-pandemic to enable exploratory analysis following recent campaigns to raise awareness and reporting of CBS. Data were extracted relating to demographics, clinical subspecialty and management strategies. Telephone surveys were used to explore psychological impact of CBS.
Results :
The pre-pandemic interval comprised 314,890 attendances, with 223 appointments reporting an established or working diagnosis of CBS (0.07%). The peri-pandemic interval comprised 259,313 attendances with 239 cases of CBS (0.09%). There was no statistically significant difference in number of new diagnoses between intervals (p=0.09, X2). Cases of CBS were most common in medical retina clinics. Proportion of females with a record of CBS was greater than males (p=0.03, One-sample binomial test). Fewer cases were registered as visually impaired at the latter interval (p=0.005, X2); however, details of clinical management strategies were more likely to be included at this interval (p=<0.001, X2). Surveys with military veterans with CBS (N=31) suggests hallucinations are often bothersome (N=17; 54.8%) with a negative impact on mood (N=7; 22.6%) and are a cause of fear (N=7; 22.6%).
Conclusions :
Cases of CBS were reported across all subspecialties of the hospital eye service. More recent records were more likely to include details of management strategies, which may be due to greater awareness. Differences in healthcare seeking behaviours may explain higher proportion of females reporting CBS, suggesting an unmet need to improve symptom reporting in males. Military veterans report CBS interfering with daily life and approximately one quarter reported being fearful of hallucinations, suggesting a need for effective coping strategies.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.