Charles Bonnet syndrome is the experience of uninvited visual phantoms appearing in those with some degree of vision impairment. The visual images seem to miraculously appear in one's field of vision. This can seem truly extraordinary when the person has significant vision loss:
"I don't get it... I can no longer read, I struggle to see what I'm doing with everyday tasks and yet I can see a man on a horse in my living room in exquisite detail.”
The type of images experienced varies enormously: rows of multi-coloured lines or intricate patterns all the way through to figures, faces, animals or buildings. They are typically not under the person's control. Without any warning, these visual images tend to spontaneously appear and at some later point, suddenly vanish. They are known as visual phantoms because even though the visual images can appear to be incredibly rich and detailed, they actually have no true substance. The images are actually empty even though they seem real or life-like. Consider the following scenario. A CBS-affected person says to a loved one:
"Darling, I know this may sound bizarre to say but I'm seeing these large orange penguins all over the walls and ceilings. Are they actually there or are my eyes playing tricks on me?"
"Sweetheart, there's no orange penguins on the walls or ceilings... so I think your eyes are playing tricks on you."
Especially at the beginning of such unusual visual experiences, one recommended approach is that the person living with CBS is encouraged to reach out with their hand and try to touch what they see. Sometimes this can be a revelation:
"I extended my arm to reach out and touch one of the orange penguins but my hand went right through the penguin and smacked against the wall. I realised that even though that orange penguin looked unbelievably real, it was actually like a mirage."
This can provide the person with a direct experience of their visual phantom and provides confirmation that some things they see are not actually there. During this initial time when CBS can truly unsettle a person, this confirmation can help the person regain some sense of control and reduce their anxiety.
The next task is to slowly begin to detect and learn what images are not real. One way is to notice whether a certain visual image comes up and then fades away but later returns again... and again. In other words, is there an image that keeps recurring? This is likely to be a CBS image. Get to know your unique images so you can remind yourself, "O there's those orange penguins again. I can ignore them because I know they're not real." Another way is to compare your visions to your everyday perception. If you live with an eye condition that no longer allows you to see things in detail or in rich colour, then images that are almost too good to be true, probably are. This can help guide you and loved ones to identify when Charles Bonnet is likely at play.
