As I've mentioned in previous blogs, I've been working at a low vision site (The Center for the Partially Sighted, or CPS), so I see many patients that have lost a significant amount of their vision. About two weeks ago, I had a patient that had lost much of his sight in his left eye (his vision was 20/200 or something like that) and had a very interesting visual complaint. He mentioned that sometimes he would notice "long strands of hair" that would suddenly hang down in front of his vision in his left eye. Since there were no signs in the back of the eye that would elicit such visual symptoms, it was concluded by the staff doctor that he had what is called Charles Bonnet Syndrome. Patients with this condition are mentally sane but have unexplained hallucinations in the eye (or eyes) that have decreased vision. They can see anything from complex, colorful patterns to animals, and these objects can even fit within the area they see e.g. a perceived small pink elephant sitting on a real couch. Most patients with low vision do not experience this syndrome, but it is definitely something to consider when patients have very outlandish visual complaints!