Charles Bonnet Syndrome: Clinical, Diagnostic, and Therapeutic Aspects – A Narrative Review of the Literature

• DOI: https://doi.org/10.22533/at.ed.515721126010610

• Palavras-chave: Charles Bonnet Syndrome; Visual Disorders; Hallucinations

• Keywords: Charles Bonnet Syndrome; Visual Disorders; Hallucinations

• Abstract:

  Charles Bonnet Syndrome (CBS) is a neurological condition characterized by the presence of complex visual hallucinations in individuals with significant visual impairment, but without cognitive, psychiatric, or consciousness-level changes. Although relatively common in patients with vision loss, it remains underdiagnosed due to healthcare professionals’ lack of awareness of the syndrome and patients’ reluctance to report symptoms for fear of being considered to have psychiatric disorders. The present study aims to review the main aspects related to CBS, including epidemiology, pathophysiology, clinical manifestations, differential diagnosis, and therapeutic approaches. This is a narrative review of the literature based on scientific articles published in national and international databases. The results demonstrate that BVS is primarily associated with age-related macular degeneration, glaucoma, cataracts, and other conditions that present with significant visual acuity loss. The most widely accepted pathophysiology involves mechanisms of sensory deafferentation and cortical hyperexcitability secondary to visual deprivation. Diagnosis is essentially clinical and depends on the exclusion of neurodegenerative, psychiatric, and neurological diseases. Management is based on patient counseling, treatment of the underlying eye disease, and, in specific cases, the use of pharmacological therapies. It is concluded that expanding knowledge about CBS is fundamental to facilitating early diagnosis, reducing patients’ emotional distress, and avoiding inappropriate interventions.