International Psychogeriatrics

Letters

“Do your eyes play tricks on you?” Asking older people about visual hallucinations in a general eye clinic

Joanna M. Jefferisa1, Urs P. Mosimanna2, John-Paul Taylora3 and Michael P. Clarkea4

a1 Research Fellow, Institute of Neurosciences and Institute for Ageing and Health, Newcastle University, Newcastle Upon Tyne, UK Email: j.m.jefferis@ncl.ac.uk

a2 Professor of Old Age Psychiatry, University of Bern, Switzerland

a3 Wellcome Intermediate Clinical Fellow, Institute for Ageing and Health, Newcastle University, Newcastle Upon Tyne, UK

a4 Consultant Ophthalmologist, Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne UK

Visual hallucinations are well recognized in individuals with low vision and intact cognition (Charles Bonnet syndrome) (Teunisse et al., 1996). Visual hallucinations also occur in those with early manifestations of dementia with Lewy bodies (McKeith et al., 2005) and Parkinson's disease dementia (Williams and Lees, 2005). Typically, visual hallucinations in these conditions are complex recurrent hallucinations of people and animals and frequently reported as being unpleasant (Mosimann et al., 2006). Individuals with visual hallucinations are often reluctant to disclose details of their symptoms (Menon, 2005), but may instead report non-specific visual difficulties to their family physician or optometrist, resulting in referral to an eye clinic. Failure to elicit the presence of visual hallucinations may lead to inappropriate treatment of age-related ocular comorbidity, such as early cataract.

(Online publication May 06 2011)