# Social Isolation as a Precipitating Factor for Charles Bonnet Syndrome in a Patient with Mild Visual Deterioration

## TL;DR

An elderly woman with mild vision loss developed Charles Bonnet Syndrome after prolonged social isolation following hip surgery.

## Contribution

This case highlights social isolation and lifestyle changes as potential triggers for CBS in mild visual impairment.

## Key findings

- CBS can occur with mild visual deterioration when combined with social isolation.
- Cognitive and social stimulation may be important in CBS management.
- Neuropsychiatric evaluation is crucial for accurate CBS diagnosis.

## Abstract

Charles Bonnet Syndrome (CBS) is characterized by complex visual hallucinations in individuals with acute vision loss, typically affecting older adults. Most CBS cases are observed in patients with sudden severe visual impairment; however, there are limited reports of CBS occurring in individuals with mild visual deterioration, particularly when confounded by sensory deprivation and social isolation. Here, we report a case of CBS in a female in her early 80s, who experienced vivid visual hallucinations during a period of prolonged social isolation following a hip surgery. Although symptomatology initially presented as delirium and psychosis, the diagnosis of CBS was confirmed after a neuropsychiatric evaluation and ophthalmologic exam, which showed mild deterioration in the patient’s macular degeneration, combined with a social history of reduced independence and increased isolation. The case highlights the lesser-known role of sudden lifestyle changes and reduced cognitive engagement in CBS development in cases of mild visual impairment. It also suggests that cognitive and social stimulation may play a crucial role in CBS management, which has limited reports in the current literature.