OBSERVATION Visual Hallucinations During Visual Recovery After Central Retinal Artery Occlusion

ized by complex, formed visual hallucinations that occur in patientswithout psychiatric disorders. To the best of our knowledge, it has not beendescribed following central reti-nal artery occlusion. Objective:Todescribe2patientswhoexperienced formed visual hallucinations characteristic of Charles Bonnet syn-drome after sudden, severe visual loss precipitated by cen-tral retinal artery occlusion. Patients: Two patients, aged 77 and 63 years respec-tively, experienced sudden deterioration of vision follow-ing central retinal artery occlusion. Formed visual hallu-cinations occurred in patient 1 six days later and in patient 2 two days later. Results: The hallucinations appeared both within and at the borders of the patients ’ residual intact visual fields. They occurred during periods when the patients expe-rienced partial visual recovery associated with enlarge-ment of their visual fields. The visual recovery and hal-lucinations both ceased at the same time. Conclusions: We propose that the hallucinations are likely the result of deafferentation and their occurrence during visual recovery suggests that they are a correlate of visual system plasticity. Arch Neurol. 2006;63:598-600 W E DESCRIBE 2 PA-tientswithpartial re-covery of visualfields over a periodof 10 to 14 weeks following central retinal artery occlusion (CRAO). During these periods of demon-strable visual recovery, the patients expe-rienced formedvisualhallucinations (some-times termed pseudo-hallucinations) characteristic of Charles Bonnet syndrome (CBS)1 bothwithin and at the borders of the residual visual field. We propose that the hallucinations are likely the result of deaf-ferentation, and their preferred emergence duringvisual recovery suggests that they are a correlate of visual system plasticity