In the spirit of Halloween, this post is based on a very eerie patient experience that I will never forget. During my second year at university, I was testing a patient whose vision was quite poor. When I asked him what he could see on the letter chart, he proceeded to tell me that he saw a man with red glasses and a snake around his neck standing right behind me in the testing room…… after looking behind me and (to my relief) realizing nothing was there… I weighed out what my options were: 1. Continue the sight test and pretend he never said that, 2. Try not to look panicked while I leave the room and seek several types of professional help, 3. Play along and ask Mr red-spex to kindly leave the room, or 4. Get a little more inquisitive about what it was the patient was actually experiencing.
I decided to go with #4 …. and the patient told me that he knew that this image he was seeing was not real. That he was in fact diagnosed with a condition known as Charles Bonnet Syndrome…. He then told me that the gentleman was leaning on my shoulder.
I came to learn that this condition is actually a lot more common than we think, and it tends to occur in people who are in fact completely mentally sound. The reason we don’t hear about it is because people are often scared that revealing this problem will make them sound like they’re losing their minds.
Charles Bonnet Syndrome occurs as a result of visual impairment. When part of the visual system is damaged beyond repair, the brain is no longer receiving all of its visual signals. The brain then decides to fill in those gaps itself with hallucinations. Some of these images are random, some are familiar, like a vision of a lost loved one, and some can be rather disturbing.
It is most common in elderly patients suffering macular degeneration (a deterioration of central vision with age) and people who are legally blind.
Unfortunately there is no cure for this condition, and there is no rhyme or reason behind what hallucination a person sees and when. But if you know a senior citizen who has mentioned ghosts or hallucinations in the past, it might be worth getting them a sight test to check the health of their eyes. It could be extremely comforting to them to know they are not going crazy and they do not need to suffer in silence.
If you’d like to learn a little more about Charles Bonnet Syndrome, check the link below for a very enlightening TED talk on hallucinations and what they mean about the brain.
In the mean time, if you see any ghosts on October 31st, just make sure they’re not trick-or-treaters before running to the optician 😉 Happy Halloween!