Charles Bonnet syndrome and phantom images

What is it: CBS is a condition which affects some people when they have lost some or all of their vision. It causes phantom images which means they see things which aren’t really there.

In healthy eyes light rays bouncing off objects around you will enter the eyes, sending electrical signals to the brain, where it is processed allowing us to see. When your eyes are affected by certain diseases your brain does not receive as much visual information. To make-up for the loss of visual information your brain may make up images or releases old images which you have stored. You see these images as if they are real.

Sometimes, people worry that phantom images are a sign of a mental health problem, but they are not. It is important to remember that for some people phantom images are their brain’s normal response to vision loss.

Always speak to your GP and eye care professional about the best treatment options for you.

Symptoms: The main symptom of CBS is phantom images. The types of images you experience may vary. Some people see imaginary objects and creatures, others see scenery and landscapes, people and animals, or shapes and patterns.

The images may be in colour or black and white, they may move or remain still and may be brief or last for a longer period of time.

Phantom images from CBS usually become less frequent or stop after one or two years, however, for some people they can last longer.

Causes: CBS is more likely in people who have lost their vision due to diseases which cause damage to the macula or retina, the light sensitive tissue at the back of the eye. These include diabetic retinopathy, glaucoma, retinitis pigmentosa and age-related macular degeneration.

Diagnosis: If you have vision loss and see phantom images it is likely that these are caused by CBS. To be sure, your doctor will check that the images aren’t from another cause such as the side effects of medication, mental health problems, or a health issue.

Treatment: There is no treatment or cure for CBS but there are some things which may help. These include:

• Talking about your experience to a friend or professional.
• Changing the environment when you see a phantom image such as increasing or dimming the lighting, moving to a different room, standing up or sitting down, or turning on some music.
• Changing your visual focus such as looking away from the image, staring at it, blinking, or moving your eyes from side to side or up and down.
• Getting enough sleep, reducing stress, and finding time for relaxation and self-care.