CPCP: Charles Bonnet Syndrome by Medical Students

Trevin Hayman M4

Trevin Hayman M4

Rolly Holcomb M4

Rolly Holcomb M4

Well, we have another great presentation from our Clinical Problems in Clinical Psychiatry (CPCP) conference. This is from a stellar couple of senior medical students, Rolly Holcomb and Trevin Hayward. They both are going into Radiology residency programs. I could tell they worked hard on this one. “Please evaluate hallucinations” is not an uncommon question for consultation psychiatrists, but we don’t usually find cases of Charles Bonnet Syndrome. It’s really not a primary psychiatric issue, but it can resemble one because of what are sometimes described by patients as funny, frightening, or odd visual hallucinations, often in the context of ocular pathology causing low vision.

I suppose Charles Bonnet Syndrome could be one way the body sort of says it would rather not go blind. On the other hand, it can make patients think they’re going crazy–and some would rather go blind than be “insane.” Reassurance is the key element of management in most of these cases, not necessarily antipsychotics.

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