Charles Bonnet Syndrome: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Charles Bonnet Syndrome?
An ophthalmologist (an eye doctor) usually cares for people with Charles Bonnet Syndrome. A primary care doctor can check for other causes, and an optician (a specialist who checks vision) can help with low vision. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is Charles Bonnet Syndrome?
Charles Bonnet Syndrome makes you see things that are not real. Doctors call these hallucinations. It can happen after you lose a lot of your sight. It is not caused by a mental health problem or dementia (a disease that affects memory and thinking). Most people who have it know the visions are not real.
The condition is common but often goes unreported. It affects up to 10% to 30% of adults with vision loss. It mostly affects older adults, but it can happen at any age after vision loss.
Symptoms
The main sign is seeing things that are not real after losing a lot of sight. The visions can:
- Be patterns like shapes or lines.
- Be people, animals, objects, or places.
- Move or stay still.
- Be black and white or color.
- Start suddenly.
- Last for a few minutes or several hours.
They are only things you see. You do not hear, smell, or feel things that are not there. The images can look vivid and detailed, and they can seem life-sized or small. Episodes can come back many times a day and can go on for months or years.
Causes and who gets it
Charles Bonnet Syndrome is linked to vision loss. When you lose sight, your brain gets less information from your eyes than it is used to. Your brain sometimes makes up for this by creating hallucinations.
You are more likely to get it if your sight suddenly gets worse or you lose sight in both eyes. It is common with eye conditions like age-related macular degeneration (an eye disease that damages the center of the eye) and cataracts (clouding of the eye's lens). It also happens with glaucoma, diabetic retinopathy, and after eye removal.
How doctors diagnose it
Doctors diagnose it by asking questions and looking for three things. These are complex visual hallucinations, documented vision loss, and no mental health or thinking problems. An eye doctor checks what is causing the vision loss. If the pattern is not typical, a nerve exam or brain scans (tests that take pictures of the brain) can rule out other causes.
Treatment
There is currently no cure, but over time the hallucinations usually happen less often. If the hallucinations suddenly return or get worse, speak to a doctor. An infection or a medicine you are taking could be the cause. Treating the infection or changing your medicine might help. If the visions are upsetting, a doctor can refer you for talking therapy.
Some simple things may help when you are hallucinating. Turn lights on or off to match the room. Move your eyes from side to side without moving your head. Stand up and move around. Watch TV or listen to the radio. Reach out to touch the vision. Rest and good sleep help, since tiredness can make it worse. Bright lights and a magnifying device (a tool that makes things look bigger) help you use the sight you have. Getting glasses and low-vision aids can cut down how often it happens. Medicine is rarely needed, but antidepressants, seizure medicines, and antipsychotic medicines have been used for severe cases, with mixed results.
When to see a doctor
If you or someone else sees things that are not real and has not been told why, ask for an urgent doctor appointment right away. It is important to rule out more serious conditions that cause hallucinations. Also speak to a doctor if the hallucinations suddenly come back or get worse. Call 911 or go to the emergency room if you have a sudden change in vision, confusion, sudden weakness, or trouble speaking.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. This doctor can check for other causes of hallucinations, review your medicines, and refer you to an eye doctor or a low-vision service.
Common questions
Is Charles Bonnet Syndrome a mental health problem?
No. It is not caused by a mental health problem or dementia. It comes with vision loss. Most people who have it know the visions are not real.
Do the hallucinations go away?
It depends. Over time, they usually happen less often. When vision improves, they may go away completely. But in some people they last for months or years.
What can I do during a hallucination?
Change the lighting, move your eyes from side to side, stand up and move around, or reach out to touch the vision. Watching TV or listening to the radio may also help.
Can Charles Bonnet Syndrome be cured?
No. There is currently no cure. But there are things that help, and medicine is rarely needed.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
