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Abstract #21634 Published in IGR 10-3
Charles Bonnet syndrome in pseudoexfoliation syndrome
Tan SK; Hazabbah WHW; Sharmini ATL; Asrenee ARInternational Journal of Ophthalmology 2008; 8: 875-877
AIM: To report a case of Charles Bonnet syndrome in advanced pseudoexfoliative glaucoma. METHODS: Case report. RESULTS: A 92-year-old Malay man presented visual hallucination for 2 years with worsening of his symptoms for the past 2 months. He claimed that he had seen people as well as hundreds of children on separate occasions vividly. He even saw a rabbit running across his room on a few occasions. However, he had insight that this was an abnormal experience. His cognitive function was normal for his age. Psychiatry evaluations including the mental status examination were normal. He was previously diagnosed as open angle glaucoma with history of uneventful cataract surgery and trabeculectomy over his left eye. His vision was hand movement in the right eye and 6/7.5 in the left eye with tunnel vision. Funduscopy of the left eye showed advanced glaucomatous optic disc cupping. He had right bullous keratopathy with absolute glaucoma and left advanced pseudoexfoliative glaucoma with functioning blebs. CONCLUSION: Elderly patient who presented visual hallucination often poses a diagnostic dilemma especially when the criteria for diagnosis of dementia and psychosis are not conclusive. In such a group of patients who possess the insight into the unreality of what they are seeing with a deteriorating vision, ophthalmologists should therefore raise the suspicion of possible Charles Bonnet syndrome.
Dr. S.K. Tan, Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian Kelantan, Malaysia. accordland@yahoo.com
Classification:
9.4.4.1 Exfoliation syndrome (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.4 Glaucomas associated with disorders of the lens)
9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
