CBS Treatments

Regrettably, many patients diagnosed with CBS are told by their health professional that there is little, if anything, that can be done for them. This is unfortunate as there are many avenues that can be explored. Whilst there is presently no one single treatment that is effective in most cases, there are a range of options available and any one of these can have a positive effect.

Visual: Medical

Optimal eye care (visual, behavioural, psycho-social) is strongly recommended. One or more of these factors can lead to a reduction in - even resolution of - CBS symptoms.

  • Ongoing visits to your eye specialist is advised to ensure monitoring of one's existing eye condition(s).
  • Relevant surgical procedures which improve vision have been known to resolve CBS (eg. removal of cataract).

 Visual: Low Vision services

  • Maximising existing vision through appropriate visual aids and localised lighting can also be beneficial.

There are documented cases of reduced - even resolved - CBS simply by the provision of improved spectacles/magnifiers, reducing glare or altering one's home lighting. Contact your local low-vision rehabilitation service provider for assistance with this matter. 

Behavioural

Challenging standard lifestyle habits can be beneficial. For example, if CBS symptoms typically occur while seated, try standing up. If they occur indoors, spend time outside. If the room is dimly lit, introduce lighting or vice versa. Blinking and rapid eye scanning techniques have also sometimes been found to be effective.

Sensory deprivation appears to be a crucial factor in CBS. Visual input reaching the brain is significantly reduced due to vision loss. On top of this, many CBS-affected persons are living lifestyles where they are further deprived of sensory stimulation. This includes rarely venturing outdoors, reduced social encounters or sitting alone in a living room that is dimly lit.  

Opportunities to stimulate the senses is strongly recommended. This could include: listening to talking books, playing music, undertaking some creative task, physical exercise, communing with nature or some tactile activity (eg. knitting, gardening or even tapping the table). All these types of activities stimulate the brain and in doing so, may reduce the likelihood of CBS.

  • Social isolation

Social isolation has been mentioned as a predisposing factor in CBS. Attempts to counter isolation and engage people in social opportunities needs to be encouraged. This could be specifically through a CBS self help group and/or general opportunities to socialise with others. If the person is home-bound, then visitors to the home or use of telephone/Skype services could also be beneficial.

  • Stress or anxiety tends to aggravate CBS. That is, phantom images can become more pronounced or frequent when one is stressed.

Consider (re-) incorporating healthy behaviours/activities into your daily life that can induce a sense of calm or relaxation. This could include: movement to music, hydrotherapy, an (re-) introduced hobby or creative endeavour.

Psycho-social

The initial experience of CBS can be one of great fear and concern. The fact that up to 65% of all people living with CBS never mention their symptoms to anyone suggests many will suffer in silence. Reassurance of the benign nature of the phantom images can be enormously liberating for the CBS-affected person. What can help put a CBS-affected person at ease includes:

  • An explanation of the underlying cause of CBS
  • Supplying a name for their condition that is not associated with mental (or memory) disturbance
  • Openly discussing the issue
  • Being supportive, empathic and non-judgmental

These factors often allow people to feel comfortable enough to disclose their CBS experiences. In turn, they feel validated by others and feel a weight off their proverbial shoulders with the reassurance the CBS label provides. 

  • Consider trying to relate to, or engage with, the images differently. 

Reacting to the phantom images in habitual ways (eg. fear, annoyance, frustration) can lock one into the experiences. Attempt to develop fresh ways to respond to the imagery. 

Pharmacological

In instances where none of the above is found to be of assistance, pharmacological treatment could be explored. There have been numerous instances of total relief from CBS as a result of prescribed medication. 

However, it also needs to be noted that current medications used to treat CBS include anticonvulsant and antipsychotic drugs. Whether these are the optimal treatment for CBS remains a matter of conjecture. Sometimes these prescribed medications:

  1. have no effect on CBS
  2. actually make the CBS symptoms worse or
  3. lead to unforeseen side effects.

Presently, there is no pharmaceutical drug that is found to be effective in most, let alone all, cases.

Electromagnetic

A more recent mode of treatment is known as repetitive transcranial magnetic stimulation (rTMS). This is a non-invasive procedure which involves the use of a magnetic coil placed over the head that can alter the degree of activity in certain regions of the brain. 

As CBS-affected persons appear to have an over-active region of the visual cortex (especially during experiences of CBS imagery), there is preliminary evidence suggesting that the application of a low frequency (1 Hz) to this area can reduce brain activity. This 'dampening' of brain activity can lead to a reduction in, or cessation of, CBS imagery.  Preliminary studies suggest that these effects can last up to a week beyond the stimulation period.