Treatments

CBS Treatments

Optimal eye care (visual, behavioural, psycho-social) is strongly recommended. One or more of these factors can lead to a reduction in - even resolution of - CBS symptoms.

Visual

  • Ongoing visits to your eye specialist is advised to ensure monitoring of one's existing eye condition(s).
  • Relevant surgical procedures by your eye specialist have been known to resolve CBS.                       (eg. removal of cataract)
  • Maximising existing vision through appropriate visual aids and localised lighting can also be beneficial. Contact your local vision rehabilitation service provider (eg. Optometrist, Orthoptist) for assistance with this matter.

Behavioural

Challenging standard lifestyle habits can be beneficial.  For example, if CBS symptoms typically occur while seated, try standing up.  If they occur indoors, spend time outside.  If the room is dimly lit, introduce lighting or vice versa.  Blinking and rapid eye scanning techniques have also sometimes been found to be effective.

Sensory deprivation appears to be a crucial factor in CBS.  Visual input reaching the brain is significantly reduced due to vision loss.  On top of this, many CBS-affected persons are living lifestyles where they are further deprived of sensory stimulation.  This includes rarely venturing outdoors, reduced social encounters or sitting alone in a living room that is dimly lit.  

Opportunities to stimulate the senses is strongly recommended. This could include: listening to talking books, playing music, undertaking some creative task, physical exercise, communing with nature or some tactile activity (eg. knitting, gardening or even tapping the table). All these types of activities stimulate the brain and in doing so, may reduce the likelihood of CBS.

Psycho-social

The initial experience of CBS can be one of great fear and concern. The fact that up to 80% of all people living with CBS never mention their symptoms to anyone suggests many will suffer in silence.  Reassurance of the benign nature of the phantom images can be enormously liberating for the CBS-affected person. What can help put a CBS-affected person at ease includes:

  • An explanation of the underlying cause of CBS
  • Supplying a name for their condition that is not associated with mental (or memory) disturbance
  • Openly discussing the issue
  • Being supportive, empathic and non-judgmental

These factors often allow people to feel comfortable enough to disclose their CBS experiences.  In turn, they feel validated by others and feel a weight off their proverbial shoulders with the reassurance the CBS label provides. 

Social isolation

Social isolation has been mentioned as a predisposing factor in CBS.  Attempts to counter isolation and engage people in social opportunities needs to be encouraged.  This could be specifically through a CBS self help group and/or general opportunities to socialise with others.  If the person is home-bound, then visitors to the home or use of telephone/Skype services could also be beneficial.

Pharmacological

In instances where none of the above is found to be of assistance, pharmacological treatment could be explored. There have been numerous instances of total relief from CBS as a result of prescribed medication. 

However, it also needs to be noted that current medications used to treat CBS include anticonvulsant and antipsychotic drugs. Whether these are the optimal treatment for CBS remains a matter of conjecture. Sometimes these prescribed medications:

  1. have no effect on CBS
  2. can actually make the CBS symptoms worse or
  3. lead to unforseen side effects.

Presently, there is no pharmaceutical drug that is found to be effective in most, let alone all, cases.

Electromagnetic

A more recent mode of (speculative) treatment is known as repetitive transcranial magnetic stimulation (rTMS).  This is a non-invasive procedure which involves the use of a magnetic coil placed over the head that can alter the degree of activity in certain regions of the brain.  As CBS-affected persons tend to have an over-active region of the visual cortex (especially during experiences of CBS imagery), there is some preliminary evidence suggesting that the application of a low frequency (1 Hz) repetitive stimulation to this area can reduce brain activity leading to a reduction or cessation of CBS imagery.  Preliminary studies suggest that these effects can last up to a week beyond the stimulation period.  

 

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