Charles Bonnet Syndrome

Written by Victoria Hamilton, Kristin Mitchell
Medically Reviewed by Brian S. Boxer Wachler, MD on March 11, 2025
6 min read

When someone is losing or has lost some or all of their ability to see, they may experience Charles Bonnet syndrome. While this fairly common condition isn’t necessarily dangerous, it can cause distress and anxiety.

As your vision weakens with time, you may start to hallucinate or see things that aren’t really there. These hallucinations can vary greatly and may include anything from patterns to very clear images, events, places, or people. Such visions are limited to your sight and won’t trigger any other senses, meaning you won’t hear or smell things that don’t exist. If you have Charles Bonnet syndrome, you’ll know that the visions aren’t real no matter how lifelike they seem.

This condition affects those who have lost or are losing their eyesight. It is more likely to happen in those with vision loss in both eyes. Charles Bonnet syndrome is linked to macular degeneration — about half of all people with macular degeneration experience hallucinations. You can get Charles Bonnet syndrome at any age, but it’s most common in people aged 80 or older, as aging is more linked to vision loss.

Hallucinations are the main symptom of Charles Bonnet syndrome. They can vary from flashes of lights to very clear, detailed forms or shapes.

Charles Bonnet syndrome hallucinations usually fall into one of two categories: patterns and detailed images. The two kinds of visions are often referred to as simple and complicated. Simple hallucinations involve patterns, and complicated hallucinations are image-based.

With simple hallucinations, you’ll see repeated patterns that might look like bright and colorful lines, shapes, or grids. These patterns will overlay your vision, meaning you’ll see them on top of the other things you typically see.

If your hallucinations consist of images, you might see people, animals, insects, places, or any variety of things. Hallucinations often happen when you wake up; however, they can also happen at any time, appear without warning, and last anywhere from a few minutes to a few hours.

The first hallucination may be startling, but once you understand what’s happening they shouldn’t be scary or unpleasant after your first time — no matter what you see.

These hallucinations may also appear as:

  • Outdoor scenes, such as waterfall or mountains
  • Imaginary images, such as unicorns or dragons
  • A line of imaginary small figures wearing costumes

The images might be in black and white and may move or be still.

The hallucinations that come with Charles Bonnet syndrome differ from those of mental health conditions because:

  • They’re linked to sight loss.
  • You’ll know that they're not reality after the first episodes.

Charles Bonnet syndrome causes aren’t known for sure, but one theory suggests that these hallucinations happen because of the brain’s reaction to suddenly losing the ability to see. The brain receives less information as vision fades, and these hallucinations could be the brain’s efforts to fill in the gaps.

There is no known cure for Charles Bonnet syndrome. It can be helpful to know that hallucinations normally happen due to vision loss and aren’t necessarily a sign of a mental health condition. There are no specific medications available for people with Charles Bonnet syndrome. However, some medications meant to treat epilepsy, Parkinson’s disease, and dementia have helped reduce hallucinations in some people, but they can have serious side effects.

You can try taking certain self-help measures when you experience hallucinations, including:

  • Change the lighting where you are. If you’re in a dark area, make it brighter, and vice versa, to see if what you’re seeing disappears.
  • Look quickly to the left and then the right. Do this 15 times without moving your head. Pause, then repeat a few more times.
  • Look straight at the hallucination or reach out to touch it, and blink quickly for a few seconds.
  • Change what you’re doing; try moving around or doing a new task.
  • Prioritize rest. Hallucinations can get worse if you’re overtired or stressed.
  • Close your eyes and look in another direction from the image.

When diagnosing Charles Bonnet syndrome, your health care provider will focus on your medical history and try to rule out other possible causes of your hallucinations. There isn’t a test dedicated to diagnosing Charles Bonnet syndrome, but they may ask you questions about:

  • Medications you take
  • Recent surgeries, such as cataract surgery
  • Mental health conditions you may have
  • Other brain conditions you may have, such as Alzheimer’s disease or Parkinson’s disease

Your doctor may also suggest neurological testing to rule out other conditions.

If you have visual hallucinations and vision loss without any other conditions, you’ll likely be diagnosed with Charles Bonnet syndrome.

Although there aren’t any health-related complications that come with Charles Bonnet syndrome, you may run into certain issues as you go about your daily activities. Challenges can include:

Difficulty with everyday tasks. Your hallucinations can make it even more difficult to see, and you could have trouble depending on how much of your sight you’ve lost and how complicated the vision is.

Initial fear of hallucinations. When you first start to experience Charles Bonnet syndrome, you might not know if what you’re seeing is real or fake. This could cause unnecessary anxiety until you get used to your condition.

Worry about other conditions. You may be concerned that you’re showing signs of a more serious issue until you learn about Charles Bonnet syndrome.

If you’re losing your vision and think you might have Charles Bonnet syndrome, get in touch with your health care provider. They, along with an optometrist and possibly an ophthalmologist, will diagnose your condition and help you learn to live with it.

Remember what you’re seeing isn’t real. Don’t act on what you see and don’t feel ashamed to talk about what you experience. Consider talking to a therapist, loved one, or Charles Bonnet syndrome support group to avoid feelings of isolation.

Charles Bonnet syndrome affects your vision as you age and causes hallucinations that can last for seconds or even years. Although there is no cure for Charles Bonnet syndrome, there are certain exercises, such as blinking or attempting to touch the images you see, that can help with the hallucinations. It’s important to let your doctor know if you have hallucinations so they can rule out other conditions such as mental health concerns.

What medication is used for Charles Bonnet syndrome?

There isn’t a specific medication or therapy for Charles Bonnet syndrome. Some anticonvulsant and antipsychotic medications may help, but symptoms also lessen on their own with time.

Can you work with Charles Bonnet syndrome?

Sometimes, the condition affects how easily you move around (like knowing if you can walk ahead because of a hallucination), but it doesn’t impact daily activities. If hallucinations occur more in dim light, then make your room brighter. Some people report moving their eyes side to side or around can help. When hallucinations appear, try doing a different activity which may reduce them.

What are the eye exercises for Charles Bonnet syndrome?

If you have a hallucination, you can try to:

  • Change the lighting in the room
  • Blinking your eyes quickly
  • Do another activity
  • Look at or reach out and touch the image

What triggers Charles Bonnet syndrome?

Charles Bonnet syndrome symptoms tend to start when you’re not active or when you wake up.