We present a series of four patients with the Charles Bonnet syndrome, which is characterized by recurrent vivid visual hallucinations in the presence of normal cognition and insight. It usually occurs in elderly people with ophthalmic pathology causing severe visual sensory deprivation. Our experience suggests that this syndrome is frequently overlooked or misdiagnosed by both ophthalmologists and psychiatrists. To our knowledge this is only the second series of cases of the syndrome in the American literature.