Charles Bonnet syndrome: a literature review into diagnostic criteria, treatment and implications for nursing practice


  • A note on nomenclature: Within the field of mental health nursing it is current practice to refer to persons receiving mental health care as ‘clients’ or ‘consumers’; however, the majority of these papers have been sourced from non-mental health publications. Consequently, in keeping with the original publications, the term ‘patient’ shall be used for consistency unless in direct reference to my own clinical experiences.

D. F. Hughes, Specialist Mental Health Service for Older People, Illawarra Shoalhaven Local Health District, 41 Junction Street, Nowra, NSW 2540, Australia, E-mail:


Accessible summary

  • • While visual hallucinations are often associated with mental illness, they often have an underlying psychical or organic cause. Impaired vision due to cataracts or macular degeneration are such an example.
  • • Antipsychotic medications may provide little or no benefit and add the risk of dangerous side effects.
  • • Mental health nurses are able to identify the condition and provide education and support to the patient which is at present, the most effective treatment.


Charles Bonnet syndrome is a disease of vision which may be mistakenly identified as manifestations of psychosis and consequently be treated by psychiatrists and mental health nurses rather than ophthalmologists. This literature review considers current understanding of the syndrome, its treatment and the role of mental health nurses. The two main findings of the review are that despite a long recognition of the syndrome, diagnostic criteria are not established and that there is no recognized evidence-based medical treatment. As well as this, two novel treatments which may offer future benefits are discussed. Current best practice is identified as identifying the condition and providing reassurance and education, a role that mental health nurses that are aware of Charles Bonnet syndrome can fulfil perhaps better than any other discipline.