Mind’s eye at work: Case series on Charles Bonnet syndrome

ABSTRACT

Charles Bonnet syndrome (CBS) manifests as complex visual hallucinations in individuals with partial or severe vision loss who otherwise retain normal cognition and insight, without evidence of psychiatric or neurological disease. Although relatively common among patients with ocular or visual pathway disorders, CBS often goes unrecognized or is mistaken for psychosis, particularly in the elderly. This case series presents three distinct presentations—an elderly woman with diabetic retinopathy, a man with occipital infarction, and another with bilateral cataracts whose hallucinations resolved following surgery. These cases underscore the need for greater clinical awareness, accurate differentiation from psychiatric conditions, and patient-centered education to alleviate distress. Early identification of CBS, especially in low-resource and aging populations, can prevent misdiagnosis and inappropriate treatment.