From the Guidelines
Patients with Charles Bonnet Syndrome (CBS) should be primarily treated with education and reassurance about the benign nature of their visual hallucinations, as this approach has been shown to provide significant relief and reduce anxiety 1. The hallucinations experienced by CBS patients are attributed to a cortical-release phenomenon resulting from a lack of afferent visual information, and techniques such as eye movements, changing lighting, or distraction may reduce hallucinations in some patients 1. Key aspects of managing CBS include:
- Educating patients and their family/caregivers about the common occurrence of phantom vision in visually impaired individuals
- Discussing the potential link between CBS and cognitive dysfunction, which is a topic of current research 1
- Recommending self-management methods such as eye movements, changing lighting, or distraction to reduce hallucinations
- Considering inhibitory transcranial direct-current stimulation (tDCS) as a potential treatment option, as a recent trial reported reduced frequency of hallucinations in subjects receiving tDCS 1 It is essential to note that atypical features, such as lack of insight into the unreal nature of the images or associated neurological signs or symptoms, should raise suspicion of a diagnosis other than CBS and warrant a medical or neuropsychiatric evaluation 1. Other treatment approaches, including pharmacological treatments, may be considered, but there is currently no significant evidence of efficacy, and education and support for patients with CBS are therapeutic 1.