June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Clinical features and practice patterns in managing patients with Charles Bonnet syndrome and characterising psychological outcomes of visual hallucinations in military veterans
Author Affiliations & Notes
  • Lee Jones
    BRAVO VICTOR, London, United Kingdom
    Institute of Ophthalmology, University College London, London, London, United Kingdom
  • Matthew Lee
    BRAVO VICTOR, London, United Kingdom
  • Lara Ditzel-Finn
    Great Ormond Street Hospital for Children NHS Foundation Trust, London, London, United Kingdom
    BRAVO VICTOR, London, United Kingdom
  • Renata Gomes
    BRAVO VICTOR, London, United Kingdom
  • Mariya Moosajee
    Institute of Ophthalmology, University College London, London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Footnotes
    Commercial Relationships   Lee Jones None; Matthew Lee None; Lara Ditzel-Finn None; Renata Gomes None; Mariya Moosajee None
  • Footnotes
    Support  This work was supported by Thomas Pocklington Trust.
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 4232. doi:
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      Lee Jones, Matthew Lee, Lara Ditzel-Finn, Renata Gomes, Mariya Moosajee; Clinical features and practice patterns in managing patients with Charles Bonnet syndrome and characterising psychological outcomes of visual hallucinations in military veterans. Invest. Ophthalmol. Vis. Sci. 2023;64(8):4232.

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      © ARVO (1962-2015); The Authors (2016-present)

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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.

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