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Article | AAO 2026

What Visual Hallucinations and Illusions Can Tell ODs About Low Vision

For optometrists, the phenomena discussed in the session provide additional context for patient reports that may initially appear inconsistent with conventional acuity and visual field findings.

By: Sarah Fackler, managing editor, Optometric Management and Eyecare Business
Optometric Management October 3, 2026

Clinical Scorecard: What Visual Hallucinations and Illusions Can Tell ODs About Low Vision

At a Glance

CategoryDetail
ConditionLow Vision
Key MechanismsVisual hallucinations, illusions, and perceptual phenomena associated with vision loss.
Target PopulationPatients with vision loss experiencing visual hallucinations or illusions.
Care SettingOptometry practice

Key Highlights

  • Visual hallucinations are common in patients with vision loss, particularly in Charles Bonnet Syndrome.
  • Distinguishing between hallucinations, illusions, and delusions is crucial for patient management.
  • Patients may not readily disclose visual phenomena; proactive education is recommended.
  • Scotomas can be perceptually filled, leading to misinterpretation of visual fields.
  • Statokinetic dissociation allows perception of motion in blind visual fields.

Guideline-Based Recommendations

Diagnosis

  • Validate the patient's chief complaint regarding visual phenomena.
  • Differentiate between hallucinations, illusions, and delusions.

Management

  • Provide management strategies and education about visual phenomena.
  • Refer for mental health evaluation when appropriate.

Monitoring & Follow-up

  • Regularly assess the patient's understanding and experience of visual phenomena.

Risks

  • Patients may experience anxiety related to visual hallucinations and misinterpretation of their symptoms.

Patient & Prescribing Data

Patients with low vision and associated visual phenomena.

Management includes education and reassurance regarding the nature of visual hallucinations.

Clinical Best Practices

  • Introduce discussions about visual phenomena proactively.
  • Use clear explanations to reduce patient anxiety about hallucinations.

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