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Study Sheds Light on Syndrome Causing Harmless Hallucinations among the Elderly

New research from the John A. Moran Eye Center at the University of Utah highlights a little-known phenomenon that can produce vivid yet harmless hallucinations among older adults as America’s population ages.

A study newly published in the Journal of Visual Impairment & Blindness by Moran Eye Center Patient Support Program Director Lisa Ord, PhD, LCSW, examines a group of patients with Charles Bonnet Syndrome (CBS).

The syndrome causes people who are experiencing vision loss to hallucinate anything from random people coming in and out of view to the Grand Canyon opening up in front of them. While it affects all ages, it’s most common among elderly patients with age-related vision conditions such as macular degeneration and glaucoma. Hallucinations generally occur while patients are sitting quietly—often alone and idle.

Animals are common in hallucinations among patients with Charles Bonnet Syndrome.
Animals are common in hallucinations among patients with Charles Bonnet Syndrome.

"Unfortunately, many people are afraid to admit to the hallucinations for fear of being diagnosed with dementia or mental illness," says Ord. "In our patient support groups and vision rehabilitation clinic at the Moran Eye Center, we explain that it’s perfectly normal. Our brains are wired to see, so much so that if the mind is robbed of the stimulation it’s used to it will fill the void by creating images that seem to come from nowhere. Unless you know the cause of these, the experience can be unnerving."

Raising awareness, offering reassurances

CBS is expected to gain in prevalence as the face of America changes. The U.S. Census Bureau projects the number of Americans age 65 years and older will increase to almost 20% of the total population, reaching 83.7 million people by the year 2050. Age-related macular degeneration and other conditions of visual loss are also projected to double.

By sharing her research, Ord aims to raise awareness of CBS, which has no established treatments but can improve with time. Her study found CBS was prevalent in 25 percent of patients attending Moran’s vision rehabilitation clinic, a majority of them women. People were the top hallucination subject, followed by animals.

Ord's clinic routinely screens for CBS.

"We want patients with partial or severe blindness and their families and physicians—to know about CBS, to reassure them that it is perfectly harmless, and to offer ways to deal with it."

How to deal with CBS-related hallucinations

One of a handful of similar programs nationwide, Moran’s Patient Support Program offers a variety of professionally moderated support groups and vision rehabilitation services to help patients, families, and caregivers find ways to understand, accept, and move past the limitations of vision loss.

Below are some of the CBS coping strategies Ord shares.

  • Blink rapidly or close your eyes for a few minutes.
  • Change the level of light by opening the drapes or turning on lights.
  • Take a nap since hallucinations tend to be more frequent when you’re tired.
  • Use relaxation techniques such as deep breathing or thinking of a happy/safe place.
  • Talk about what you are experiencing; interacting with others can help stop hallucinations.
  • Walk away; physically moving to another location can eliminate hallucinations.
  • Become familiar with "people" hallucinations so they don’t frighten you.
  • Develop a new hobby, exercise, or become more socially engaged to increase your sensory stimulation.