Bill Harvey: Sound and vision

Dealing with Charles Bonnet Syndrome is both a fascinating challenge for eye care practitioners, and an excellent example of how our communication skills can make a real difference.

I was reminded of this last weekend when confronted with a patient reporting vision loss related to early macular degeneration. Only after careful questioning did she reveal, as is often the case, incidents of ‘spiders or crabs’ running across her bedroom. More worryingly, she had seen a figure in her kitchen one evening dressed in brightly coloured Regency-period costume. I took great pains explaining that the condition was common and transient, and might be looked at as evidence that, despite retinal changes, her visual system was fully working and trying to fill in the gaps – I attempted an analogy of a fully working car with faulty headlights. I also reassured her that a majority of people were not disturbed and actually enjoyed the colours in each hallucination which her eyes no longer could detect. I could sense her relief and believe she will be less concerned when she has future illusions.