Description of CBS symptoms, clinical management decisions and patient-reported impact of hallucinations
| ID | Description of CBS symptoms | Reporting HCP | CBS management | CBS impact |
|---|---|---|---|---|
| 01 | No specific descriptors | Consultant ophthalmologist | Prescribed antipsychotic medication (risperidone) | Symptom onset when tired and/or stressed after overexertion. Withdrawal from university due to symptoms |
| 02 | Complex—people, faces, prosopometamorphopsia Simple: flashing lights | Consultant paediatrician | Second opinion sought with paediatric ophthalmologist. Referred for further brain imaging (MRI) | Finding life stressful and missing meals |
| 03 | Simple: shapes | LVA optometrist | Not described | Symptoms occurring since age 6, but reported age 12 years |
| 04 | Simple: flashing lights | Ophthalmologist-in-training | Provision of tinted glasses for bright lights. Inform about potential strategies to reduce symptoms | Images not considered upsetting |
| 05 | Simple: linear patterns and spots | Ophthalmologist-in-training | Provided an information leaflet | Not described |
| 06 | Simple: visual phenomena | Ophthalmologist-in-training | Not described | Not described |
| 07 | Simple: visual phenomena | Ophthalmologist-in-training | Provided an information leaflet and arranged appointment with family support worker | Not described |
| 08 | Simple: patch resembling silver line or bar, appearing and disappearing occasionally seen in multiples | LVA optometrist | Advised to ask for further medical opinion at next hospital review | Not described |
| 09 | Simple: visual phenomena | Consultant ophthalmologist | Provided verbal information on CBS in clinic | Not described |
| 10 | Simple: visual disturbance | Clinician-in-training | Provided verbal information on CBS in clinic | Not described |
| 11 | Complex: menacing faces, prosopometamorphopsia Simple: shapes | LVA optometrist | Referred to consultant neuro-disability paediatrician and paediatric counsellor. Advised quiet story at bedtime and prescribed melatonin (2 mg) to help sleep disturbances. Provided verbal information on CBS in clinic. Directed to support group. Advised to contact GP for further help | Frightened. Very upset. Disrupted sleep. Symptoms feature more frequently at night particularly when anxious or stressed |
| 12 | No specific descriptors | Optometrist | Contacted by family support | Regular nightmares |
| 13 | Complex: animals | Ophthalmologist-in-training | Not described | Not described |
CBS, Charles Bonnet syndrome; GP, general practitioner; HCP, healthcare professional; LVA, low-vision assessment.