If you’re seeing people, patterns, or animals that aren’t there, you’re likely not having a mental health crisis if you have age-related macular degeneration (AMD). AMD, which is one of the most common causes of visual impairment, can also cause visual hallucinations.

These hallucinations, known as Charles Bonnet syndrome (CBS), were once considered a rare occurrence, but they may be more common than originally thought. People with AMD sometimes don’t mention these visual disturbances for fear of being labeled with a mental illness.

Here’s what you need to know about CBS and its connection to AMD, including what causes it, what the hallucinations look like, and how to reduce their occurrence.

What Is Charles Bonnet Syndrome and How Is It Related to AMD?

Charles Bonnet syndrome, also called visual release hallucinations, is a condition that causes people with vision loss to experience hallucinations or see images that aren’t real.

CBS sometimes occurs in people with AMD as well as in those with diabetic retinopathy, glaucoma, and retinal detachment. A study found that CBS occurs in about 16 percent of people with AMD overall.

These hallucinations are usually temporary and aren’t related to mental health conditions or behavioral disorders. People experiencing these hallucinations also know the images they’re seeing aren’t real — unlike those experiencing hallucinations caused by psychosis or dementia.

Typically, these visual hallucinations last for a few seconds or several minutes but some can last hours. They will also come and go for about one to two years before tapering off.

What Causes CBS?

When your vision is normal, light enters your eye and travels to the retina in the back of your eye. The retina then converts the light into visual messages that allow you to see the world around you.

But if you have vision loss from a condition like AMD, your eyes aren’t processing new information as well as before. This can cause your brain to compensate by making up new images or recalling images you’ve seen in the past in order to fill this gap in vision. This causes a visual hallucination.

CBS Risk Factors

Those with significant vision loss or vision loss in both eyes are usually the most likely to experience these hallucinations. According to StatPearls, you’re also at an increased risk for CBS if you are older than 65 or if you’re female, which may be due to the fact that women tend to live longer than men.

Living alone or being socially isolated can also increase your risk of CBS. And spending a lot of time indoors with very little natural light can heighten your risk as well. Even stress or a loss of sleep can make hallucinations more prevalent.

If you have Alzheimer’s disease, Parkinson’s disease, or another condition that affects the brain, tell your doctor about any hallucinations. These conditions can also cause hallucinations, so your doctor may want to check whether another condition is contributing to your symptoms.

What Kinds of Visual Hallucinations Will You See?

If you have CBS, the images or hallucinations you see may include complex images like faces, people, or animals. Or they can appear as lines, shapes, or flashes of light. Some people even see gridlike patterns or lattices.

Others report seeing gardens, costumed figures, and disembodied faces with staring eyes. For many, these visions are more intense or detailed than what they see everyday. The hallucinations can also be worrisome or upsetting, especially if you don’t know the cause.

Here are some other characteristics of CBS-related hallucinations:

• Clear, vivid images that are more intense with your eyes open
• Images that are in color or in black and white
• Silent images
• Still images
• Images that look like a moving picture

It’s possible that you’ll see the same images over and over again. Or you may see something new or different every time a hallucination occurs. CBS hallucinations are different for everyone.

How Do CBS-Related Hallucinations Differ From Other Hallucinations?

Hallucinations caused by other conditions like mental illnesses or psychosis have characteristics that aren’t present in CBS. The biggest difference is that people with CBS know what they’re seeing isn’t real while those with hallucinations caused by some other conditions may not always realize this.

Here are two other key differences.

CBS-related hallucinations aren’t accompanied by sound. They don’t talk or make noise. Meanwhile, those having hallucinations related to other conditions often hear voices or sounds alongside the images they see.

If you have CBS, your hallucinations may include more than animals or people. You may also see webs, netting, or grids.

Meanwhile, those with hallucinations caused by a different condition primarily see people and animals and rarely see patterns, shapes, or lines. They may also offer elaborate descriptions and explanations of their hallucinations and what they hear.

Can You Reduce the Frequency of Hallucinations?

If you have AMD and have started developing the symptoms of CBS, there aren’t many treatments for the condition. But there are ways to help reduce the risk of hallucinations.

To help keep hallucinations from occurring or to make the images go away once they start, you can try the following:

• Make sure you get plenty of sleep and reduce your stress.
• Increase the amount of time you spend in brightly lit rooms or outside.
• Try blinking your eyes or turning away from the hallucination.
• Move your eyes up and down or from side to side.
• Stare at the hallucination to see if it goes away.
• Try to touch the image to see if you can disrupt the hallucination.
• Turn on the television or radio if you tend to see hallucinations when it’s quiet.

How Do You Cope With CBS-Related Hallucinations?

Experiencing visual hallucinations along with having impaired vision can be distressing, frustrating, and upsetting. It can also impact your emotional health and your quality of life.

If your hallucinations cause anxiety or interfere with your daily life, talk with your medical team. Antianxiety medications may help with anxiety, but they do not treat CBS itself. Counseling or cognitive behavioral therapy may also help you cope with distressing hallucinations.

Spending time with friends and family can help you keep your mind busy and engaged when managing CBS.

Consider joining a support group and connecting with others who have CBS. They may be able to offer suggestions and provide a safe place for you to share your experiences and your concerns. Being around others with the same condition can be very reassuring.

Join the Conversation

On myAMDteam people share their experiences with AMD, get advice, and find support from others who understand.

If you’ve been diagnosed with CBS, what types of hallucinations do you experience and how do you manage those? Let others know in the comments below.