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visual release hallucinations
Visual release hallucinations, also known as Charles Bonnet syndrome (CBS), is the experience of complex visual hallucinations in a person with partial or severe blindness. First described by Charles Bonnet in 1760,〔de Morsier G (1967)"Le syndrome de Charles Bonnet: hallucinations visuelles des vieillards sans deficience mentale" (in French). ''Ann Med Psychol'' 125:677–701.〕〔Vukicevic M, Fitzmaurice K (2008) "Butterflies and black lacy patterns: the prevalence and characteristics of Charles Bonnet hallucinations in an Australian population". ''Clinical and Experimental Ophthalmology. 36'':659–65〕 it was first introduced into English-speaking psychiatry in 1982.〔Berrios G E and Brook P (1982) The Charles Bonnet Syndrome and the Problems of Visual Perceptual Disorder in the Elderly. ''Age and Ageing'' 11: 17–23〕
==Signs and symptoms==
Mentally healthy people with significant vision loss may have vivid, complex recurrent visual hallucinations (fictive visual percepts). One characteristic of these hallucinations is that they usually are "lilliputian" (hallucinations in which the characters or objects are smaller than normal). The most common hallucination is of faces or cartoons. Sufferers understand that the hallucinations are not real, and the hallucinations are only visual, that is, they do not occur in any other senses, e.g. hearing, smell or taste.〔Schultz G, Melzack R (1991) "The Charles Bonnet Syndrome: phantom visual images". ''Perception''. 20:809–25〕〔Mogk LG, Riddering A, Dahl D, Bruce C, Brafford S (2000) "Charles Bonnet Syndrome in adults with visual impairments from age-related macular degeneration. In Stuen C et al. ''Vision Rehabilitation: Assessment, Intervention and Outcomes.''117–119〕 Among older adults (> 65 years) with significant vision loss, the prevalence of Charles Bonnet syndrome has been reported to be between 10% and 40%; a recent Australian study has found the prevalence to be 17.5%.〔 Two Asian studies, however, report a much lower prevalence.〔Tan C, Lim V, Ho D, Yeo E, Ng B, Au Eong K. (2005)"Charles Bonnet syndrome in Asian patients in a tertiary ophthalmic centre". ''British Journal of Ophthalmology.''88(10):1325–9〕〔Abbott E, Connor G, Artes P, Abadi R. "Visual Loss and Visual Hallucinations in Patients with Age-Related Macular Degeneration (Charles Bonnet Syndrome)". ''Investigative Ophthalmology and Visual Science.''48:1416–23.〕 The high incidence of non-reporting of this disorder is the greatest hindrance to determining the exact prevalence; non-reporting is thought to be a result of sufferers being afraid to discuss the symptoms out of fear that they will be labelled insane.〔
People suffering from CBS may experience a wide variety of hallucinations. Images of complex colored patterns and images of people are most common, followed by animals, plants or trees and inanimate objects. The hallucinations also often fit into the person's surroundings.〔
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