I See Purple Flowers Everywhere:
The Many Visions of Charles Bonnet Syndrome
Money
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"I See Purple Flowers Everywhere: The Many Visions of Charles Bonnet Syndrome" By Lylas G. Mogk, MD, and Marja Mogk, Phd;
Do you ever see things you know are not there but look real anyway? It's a common side effect among people with vision impairment. While we refer to it as "phantom vision," the technical term is "Charles Bonnet Syndrome." If you've experienced this, rest easy. Your mind is fine. It's your eyes that are playing tricks on you.
What Exactly is Charles Bonnet Syndrome? Charles Bonnet, an 18th century Swiss naturalist and philosopher, is credited as the first person to describe the syndrome. Like his grandfather, who had low vision and saw men, women, birds and buildings he knew were not there, Charles experienced similar phantom visions when his own vision deteriorated. One explanation compares this condition to phantom limb experiences. People who have a limb amputated may still feel their toes or fingers, or may experience itching on an arm that is not there. This happens because the limb's nerves are still active and sending signals to the brain, which the brain interprets as sensations from the missing limb. Similarly, when retinal cells become impaired and are no longer able to receive and relay visual images to the brain, the visual system begins firing off images on its own. Often, these images are not related at all to a person's life. Sam, who has macular degeneration, said, "I see little monkeys with red hats and blue coats playing in the front yard." Sam had no doubt that the monkeys he saw were not real ones. As a result, he wasn't concerned about his mind. However, he was worried about what others would think, so he kept it to himself.
Is the Syndrome Common? Studies show that Charles Bonnet Syndrome affects between 10 and 40 percent of people with low vision. Our research suggests that it is more likely to appear if you have visual acuity between 20/120 and 20/400. If your vision falls between these parameters, your eyes still have a great deal of power, even though they aren't receiving or sending as many images as previously. As a result, your eyes may be providing additional images of their own. We can't predict whether you will see images and, if you do, how frequently they will occur or how long they will last.
Are You Sure This Is Not a Psychiatric Problem? Yes! Charles Bonnet Syndrome is no more than a side effect of vision loss. The six criteria for Charles Bonnet Syndrome (outlined by Naville in 1873 - and still applicable today) can help you determine whether or not you are experiencing phantom vision.
• They occur when you are fully conscious and wide awake, often during broad daylight. • They do not deceive you; you are aware that they are not real. • They occur in combination with normal perception. For example, you may see a sidewalk clearly but find it covered with dots, flowers or faces. • They are exclusively visual and do not appear in combination with any sounds or bizarre sensations. • They appear and disappear without obvious cause. • They are amusing or annoying but not grotesque.
Is Charles Bonnet Syndrome Treatable? While there does not seem to be any specific medications that work for everyone, many people find that learning more about the condition helps to reassure them. A majority of people do not find their phantom vision disturbing, probably because the images are amusing, pleasing or entertaining. Lighthouse International - Fall 2004 |
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| MONEY MATTERS Developing systems for indentifying and handling money is critical for maintaining an independent lifestyle. One example:
Paper Money • Sort bills and place them in different sections of your wall, and/or fold them according to different denominations. You might want to try this method to differentiate four denominations of paper money.
• One dollar bills unfolded in your wallet • Five dollar bills in half with short ends together; fold • Ten dollar bills in half with long sides together; fold • Twenty dollar bills in half, and then in half again.
• When you receive bills, fold or otherwise identify them before placing them in your wallet. • Create sections in your wallet with flexible plastic, or simply purchase a sectioned wallet.
Coins • Identify coins by touch. Some coins have smooth edges; others have rough edges. Use your fingernail for easier identification. • Pay attention to coin size to distinguish between coins with similar edges (i.e., smooth or rough). For example, in the United States, with smooth-edged coins, the nickel is larger than the penny; with rough-edged coins, the quarter is larger than the dime.
Banking • Contact your local bank for specialized or accessible service options, such as banking by phone, online banking, accessible ATMs, specially trained service representatives and more. If you request them, some banks provide statements in large print, braille or on cassette. • Find out if your bank offers large-print checks or check styles with raised lines. • Use commercial check guides - opaque templates with openings to match a standard check, which will show you where you need to fill in standard information (signature, date, amount, etc.). Vision Connection, October 2004
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Medicare Legislation News The Medicare bill, passed by Congress in late November, legislates a one-year study to produce recommendations by January, 2005 for legislative action �providing for payment for vision rehabilitation services furnished by vision rehabilitation professionals.� Other legislation expected to be passed this year would establish a funded, five-year demonstration project to provide vision rehabilitation services where they are most needed: at home and in the community.
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