Neuro-ophthalmology and pupils: visual release hallucinations: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Ophthalmology · Neuro-ophthalmology and pupils: visual release hallucinations

Sample item

An 80-year-old woman with advanced macular degeneration sees vivid, well-formed pictures of people and animals. She knows they are not real and has no cognitive decline. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Charles Bonnet syndrome

Visual loss can release complex visual hallucinations in people with intact cognition and insight. Charles Bonnet syndrome is common in advanced macular disease and requires reassurance rather than antipsychotics. Hallucinations with loss of insight and cognitive decline suggest dementia instead.

Option by option

  • A. Charles Bonnet syndrome (correct)

    Correct. Complex hallucinations with insight and poor vision are Charles Bonnet syndrome.

  • B. Temporal lobe epilepsy

    Temporal lobe epilepsy produces brief stereotyped episodes with altered awareness.

  • C. Delirium tremens

    Delirium tremens occurs after alcohol withdrawal with agitation and autonomic signs.

  • D. Lewy body dementia

    Lewy body dementia causes hallucinations with cognitive fluctuation and parkinsonism.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is A, Charles Bonnet syndrome. Visual loss can release complex visual hallucinations in people with intact cognition and insight.

Why is "Temporal lobe epilepsy" not the answer?

Temporal lobe epilepsy produces brief stereotyped episodes with altered awareness.

Why is "Delirium tremens" not the answer?

Delirium tremens occurs after alcohol withdrawal with agitation and autonomic signs.

Why is "Lewy body dementia" not the answer?

Lewy body dementia causes hallucinations with cognitive fluctuation and parkinsonism.

What concept does this question test?

It tests Neuro-ophthalmology and pupils: visual release hallucinations in Ophthalmology. Charles Bonnet syndrome is common in advanced macular disease and requires reassurance rather than antipsychotics. Hallucinations with loss of insight and cognitive decline suggest dementia instead.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuro-ophthalmology and pupils: visual release hallucinations?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.