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Visual release hallucinations
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==Signs and symptoms== People with significant [[vision loss]] may have vivid recurrent visual hallucinations (fictive visual percepts).<ref name=":1" /> One characteristic of these hallucinations is that they usually are "[[lilliputian hallucination|lilliputian]]" (hallucinations in which the characters or objects are smaller than normal).<ref>{{Cite journal |last1=Vojniković |first1=Bozo |last2=Radeljak |first2=Sanja |last3=Dessardo |first3=Sandro |last4=Zarković-Palijan |first4=Tija |last5=Bajek |first5=Goran |last6=Linsak |first6=Zeljko |date=2010 |title=What associates Charles Bonnet syndrome with age-related macular degeneration? |journal=Collegium Antropologicum |volume=34 |issue=Suppl 2 |pages=45–48 |issn=0350-6134 |pmid=21305724}}</ref> Depending on the content, visual hallucinations can be classified as either simple or complex.<ref name=":1" /> Simple visual hallucinations are commonly characterized by shapes, [[photopsia]]s, and grid-like patterns.<ref name=":0">{{Cite journal |last=Pang |first=Linda |date=2016 |title=Hallucinations Experienced by Visually Impaired: Charles Bonnet Syndrome |journal=Optometry and Vision Science |language=en-US |volume=93 |issue=12 |pages=1466–1478 |doi=10.1097/OPX.0000000000000959 |issn=1538-9235 |pmc=5131689 |pmid=27529611}}</ref> Complex visual hallucinations consist of highly detailed representations of people and objects.<ref name=":0" /> The most common hallucination is of faces or cartoons.<ref name="ted">{{Cite web |last=Sacks |first=Oliver |author-link=Oliver Sacks |title=What hallucination reveals about our minds |url=http://www.ted.com/talks/oliver_sacks_what_hallucination_reveals_about_our_minds.html |url-status=live |archive-url=https://web.archive.org/web/20130708194612/http://www.ted.com/talks/oliver_sacks_what_hallucination_reveals_about_our_minds.html |archive-date=2013-07-08 |access-date=2013-07-03 |publisher=Ted.com}}</ref> Those affected [[Pseudohallucination|understand that the hallucinations are not real]], and the hallucinations are only visual.<ref>{{Cite journal |last1=Schultz |first1=G |last2=Melzack |first2=R |year=1991 |title=The Charles Bonnet syndrome: 'phantom visual images' |journal=Perception |volume=20 |issue=6 |pages=809–25 |doi=10.1068/p200809 |pmid=1816537 |s2cid=22318715}}</ref><ref name="Mogk/Riddering/Dahl/Bruce/Brafford">{{Cite book |last1=Mogk |first1=Lylas G. |author-link=Lylas Mogk|title=Vision Rehabilitation |last2=Riddering |first2=Anne |last3=Dahl |first3=David |last4=Bruce |first4=Cathy |last5=Brafford |first5=Shannon |publisher=CRC Press |year=2000 |isbn=978-90-265-1631-3 |editor-last=Arditi |editor-first=Aries |pages=117–9 |chapter=Charles Bonnet Syndrome In Adults with Visual Impairments from Age-Related Macular Degeneration |editor-last2=Horowitz |editor-first2=Amy |editor-last3=Lang |editor-first3=Mary Ann |editor-last4=Rosenthal |editor-first4=Bruce |editor-last5=Seidman |editor-first5=Karen |editor-last6=Stuen |editor-first6=Cynthia |chapter-url={{Google books|mve0LPp6_pUC|page=117|plainurl=yes}}}}</ref> Visual hallucinations generally appear when the eyes are open, fading once the visual gaze shifts.<ref name=":1" /> It is widely claimed that sensory deprivation is instrumental in the progression of CBS.<ref name=":2" /> During episodes of inactivity, hallucinations are more likely to occur.<ref name=":1" /> The majority of those with CBS describe the duration of hallucinations to continue for up to a few minutes, multiple times a day or week.<ref name=":1" /> Even though people of all ages may be affected by Charles Bonnet syndrome, those within the age range of 70 to 80 are primarily affected.<ref name=":1" /> Among older adults (> 65 years) with significant vision loss, the prevalence of Charles Bonnet syndrome has been reported to be between 10% and 40%; a 2008 Australian study found the prevalence to be 17.5%.<ref name="Vukicevic/Fitzmaurice" /> Two Asian studies, however, report a much lower prevalence.<ref>{{Cite journal |last1=Tan |first1=C S H |last2=Lim |first2=V. S. |last3=Ho |first3=D. Y. |last4=Yeo |first4=E |last5=Ng |first5=B. Y. |last6=Au Eong |first6=K. G. |year=2004 |title=Charles Bonnet syndrome in Asian patients in a tertiary ophthalmic centre |journal=British Journal of Ophthalmology |volume=88 |issue=10 |pages=1325–9 |doi=10.1136/bjo.2004.041947 |pmc=1772345 |pmid=15377560}}</ref><ref>{{Cite journal |last1=Abbott |first1=Emily J. |last2=Connor |first2=Gillian B. |last3=Artes |first3=Paul H. |last4=Abadi |first4=Richard V. |year=2007 |title=Visual Loss and Visual Hallucinations in Patients with Age-Related Macular Degeneration (Charles Bonnet Syndrome) |journal=Investigative Ophthalmology & Visual Science |volume=48 |issue=3 |pages=1416–23 |doi=10.1167/iovs.06-0942 |pmid=17325191 |doi-access=free}}</ref> The high incidence of underreporting this disorder is the greatest hindrance to determining the exact prevalence.<ref name="Mogk/Riddering/Dahl/Bruce/Brafford" /> Underreporting is thought to be a result of those with the condition being afraid to discuss the symptoms out of fear that they will be labeled of unsound mind.<ref name="Mogk/Riddering/Dahl/Bruce/Brafford" />
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