VISUAL HALLUCINATIONS IN THE ELDERLY

Visual hallucinations, without auditory hallucinations and in the elde rly, are not usually based on previous psychiatric illness. The elderl y can, of course, hallucinate as part of severe depression or a life-l ong schizophrenia, but the clinician should assume that there is an or ganic basis when an elderly individual begins to develop visual halluc inations for the first time. Representative cases that illustrate visu al hallucinations due to ophthalmological, vascular, or degenerative p rocesses are presented. Visual hallucinations can be linked to disorde rs in multiple parts of the nervous system. Even when related to medic ations, dementia may also be contributory, as is illustrated by the ha llucinations seen in those with Parkinson's disease. Treatment of visu al hallucinations is treatment of the underlying cause although some n ewer drugs such as clozapine may also be helpful for selected patients .