# Postoperative Hallucinations or Reality: Can Patients Differentiate Between Hallucinations and Reality?

## TL;DR

This paper discusses a case where a patient could tell the difference between post-surgery hallucinations and reality, which is important for understanding delirium in ICU patients.

## Contribution

The novelty lies in presenting a case where a patient with postoperative delirium recognized hallucinations as non-real.

## Key findings

- A patient with postoperative delirium experienced vivid hallucinations but could distinguish them from reality.
- The patient's ability to recognize hallucinations was aided by her awareness of her extreme myopia.
- Medical records confirmed the hallucinations, highlighting the importance of clinical observation in delirium cases.

## Abstract

Delirium is the most common psychiatric complication after surgery and is known to be a source of distress for patients. During the course of postoperative delirium, patients may experience hallucinations and can sometimes confuse these hallucinations with reality. We present a patient who experienced vivid hallucinations in the ICU after surgery that were indistinguishable from reality. The patient, a woman in her 20s, was admitted to the ICU after surgery and was confused because she felt that other patients had made sexual comments to her. However, the patient was able to recognize them as hallucinations because, despite her extreme myopia, she could clearly see her surroundings. A detailed examination of the medical records allowed the medical team to also determine that they were hallucinations. Healthcare professionals should be aware that patients may experience hallucinations that are indistinguishable from reality.