PT  - JOURNAL ARTICLE
AU  - Lee Jones
AU  - Mariya Moosajee
TI  - Visual hallucinations and sight loss in children and young adults: a retrospective case series of Charles Bonnet syndrome
AID  - 10.1136/bjophthalmol-2020-317237
DP  - 2021 Nov 01
TA  - British Journal of Ophthalmology
PG  - 1604--1609
VI  - 105
IP  - 11
4099  - http://bjo.bmj.com/content/105/11/1604.short
4100  - http://bjo.bmj.com/content/105/11/1604.full
SO  - Br J Ophthalmol2021 Nov 01; 105
AB  - Background/Aims Charles Bonnet syndrome (CBS) is a complication of sight loss affecting all ages; yet, few childhood cases have been reported. Our aim is to raise awareness of this under-reported association occurring in children and young adults in order to prevent psychological harm in this age group.Methods A retrospective case series reviewing medical notes of patients <25 years of age with sight loss and reported CBS at a single centre hospital eye service in London, United Kingdom. Search of electronic patient records identified 13 patients experiencing hallucinatory events over a 9-year period. Outcomes were patient demographics including ocular diagnosis, visual acuity at time of onset, characteristics of hallucinations, clinical management strategies and patient-reported affliction.Results Eight patients were diagnosed with progressive inherited retinal diseases, primarily Stargardt disease (N=5). Clinical history indicated patients had significantly reduced best-corrected visual acuity (BCVA) in at least one eye at onset; median (IQR) worse eye BCVA was 1.0 (0.86–1.6) logarithm of minimum angle of resolution(LogMAR). CBS significantly affected patients’ personal lives including education, diet and sleep. Clinical management was varied, mostly relating to reassurance at the point of contact.Conclusion We describe the clinical features of young patients with CBS, with management strategies and aspects of negative outcomes. High potential caseload and risk of psychological harm merit further research. Increased awareness among healthcare professionals and patient education to forewarn susceptible individuals may reduce the overall impact and improve coping with symptoms.