Chloropsia in the Charles Bonnet syndrome

PURPOSE: Chloropsia (green-colored vision) is an extremely uncommon and relatively unstudied clinical finding. We report a case where cerebral chloropsia was the presenting symptom of the Charles Bonnet syndrome. OBSERVATIONS: A 66-year-old male physician with a previous ocular history of advanced bilateral primary open-angle glaucoma presented with acute, diffuse chloropsia, which he described as “light green and oval-shaped.” The patient was not taking any drugs that commonly cause altered color perception and did not have a previously diagnosed psychiatric disorder. Ophthalmic examination findings showed poor visual acuity, central visual field loss, and altered color perception in both eyes. Common laboratory tests and visual imaging showed no abnormalities that could be associated with the patient's symptoms. CONCLUSIONS AND IMPORTANCE: Our patient meets all diagnostic criteria for Charles Bonnet syndrome, even though, to the best of our knowledge, chloropsia has never been previously associated with this disorder. Physicians should monitor patients for altered color perception, which cannot be explained by other ocular, psychiatric, or systemic mechanisms, as this could be a sign of Charles Bonnet syndrome.