# Review of Risk Factors, Pathophysiology, Management Principles, and Role of Medications

## TL;DR

This case report discusses a patient with Charles Bonnet syndrome who experienced visual hallucinations without psychosis, highlighting the challenges in managing such cases.

## Contribution

The report introduces the concept of 'atypical CBS' to describe cases with reduced insight or additional hallucinatory features.

## Key findings

- The patient experienced complex visual hallucinations without underlying psychosis or dementia.
- Antipsychotic medication's role in CBS remains uncertain due to the absence of true mental illness.
- The term 'atypical CBS' is proposed for cases with cognitive deficits or other hallucinatory modalities.

## Abstract

This is a case report of one patient experiencing psychotic symptoms in the setting of Charles Bonnet syndrome (CBS). Case description is included, and patient has been deidentified. Patient's consent could not be obtained for the submission of the report. The case report focuses on understanding and formulating key psychological issues addressed in this case. It is important to identify that the absence of psychotic illness is classical in patients presenting with psychotic symptoms in CBS and the role of antipsychotic medication is uncertain. A literature review on the management of CBS guidelines published across the world and summarization of the management approach applicable to this case. Visual hallucination is a perception of a visual stimuli when none exists. CBS is characterized by the presence of complex visual hallucinations experienced by the visually impaired, i.e., in an individual with ocular pathology causing vision loss without having true psychosis or dementia. Furthermore, the person having these experiences has a preserved insight into the unreal nature of the perceptions and the absence of mental disorders. An introduction to the terminology “atypical CBS” or “CBS plus” was done to consider visual hallucinations in individuals with low level of insight in a setting of possible cognitive deficits or other hallucinatory modalities.