Notwithstanding the curiosity that it raises in the psychiatric community, the Charles Bonnet Syndrome is still an entity of poor defined contexts, especially in what concerns to its therapeutic management. It consists in complex visual hallucinations in visually impaired patients that possess insight into the unreality of their visual experiences and have no past history of major psychiatric disturbances or cognitive impairment. This syndrome is sub-diagnosed and, perhaps for that, is considered rare. The prevalence of complex visual hallucinations in patients with diminished visual acuity varies between 0,4 and 15%; reports from different authors point to an average of around 10%. The most consensual theory about the origin of the hallucinations is that they result from a process of de-afferentation of the visual association areas of the cerebral cortex, leading to a phenomenon called “phantom vision”.

The present communication focus on the clinical case of a 65 years-old women, retired, divorced, socially isolated, with no previous major psychiatric disturbances or cognitive impairment. Her visual deficits resulted from complications of severe myopia. In the past year, she has started with visual complex hallucinations, in the form of people, animals and scenes, without special personal meaning. The patient lives this phenomenon with severe distress.

Neuroimaging study failed to find any abnormality. Treatment started with risperidone, carbamazepine and psychotherapy based on reassurance and counselling, to witch there was partial response.

The authors emphasize particular clinical aspects and management of this case and present main data published in literature about Charles Bonnet Syndrome.