Charles Bonnet syndrome in children

Abstract

Charles Bonnet syndrome (CBS) is characterized by the presence of complex visual hallucinations in psychologically healthy but visually impaired people.1 It has been well described in the adult population but has been less well characterized in children. This report describes CBS in 2 children, both of whom had diagnoses of cone-rod dystrophy. After previously normal visual experience, each underwent rapid visual deterioration between 6 and 8 years old. Formed visual hallucinations were noted shortly after loss of vision. The children's symptoms were identical to those described by adults with CBS. Formed visual phenomena included geometric shapes, people, and buildings. Images, which were both stationary and in motion, were described as interesting or entertaining and only rarely as frightening. No other senses were affected (no auditory component). Sixteen additional children with diseases of the eye or optic nerves were questioned about symptoms of CBS, including children with congenitally decreased vision, children with slowly progressive visual loss but current vision better than 20/200, and children with early normal vision who had profound vision loss before 4 years old; all these children denied hallucinations. Copyright © 1998 by the American Association for Pediatric Ophthalmology and Strabismus.