An 86-year-old woman with a history of arterial hypertension, dyslipidemia, heart failure, glaucoma, anxiety-depressive disorder, and blindness (visual acuity in the right eye 0.05% and left eye 30%). She previously underwent cataract surgery. Current treatment includes sacubitril/valsartan, nebivolol, furosemide, and atorvastatin. No toxic habits. She presents to the primary care consultation due to visual hallucinations—seeing trees and flowers on the walls of her living room for the past two days.The patient was conscious, oriented, without amnesic failures, and with coherent and fluent speech. Physical and neurological examination was unremarkable except for reduced visual acuity. She had not started new treatments, nor had she suffered trauma or other neurological focality. Blood tests, serologies, urinalysis, toxicology screening, dementia tests, and a cranial CT scan were performed, all with unremarkable results. An ophthalmology consultation was requested, where fundus examination and macular optical coherence tomography were performed, with no relevant findings. The most likely diagnosis was Charles Bonnet syndrome.Charles Bonnet syndrome (CBS) is a phenomenon characterized by vivid, complex visual hallucinations—well-defined, realistic images of objects or people—that occur when the patient is awake and mostly with eyes open, in individuals with visual impairment and no neurological deficits, as described by Rojas LC, Gurnani B et al. The most widely accepted current theory suggests that visual sensory deafferentation leads to disinhibition of cortical regions involved in vision, which results in spontaneous activation and produces hallucinations.This syndrome may go unnoticed and can be misdiagnosed as early dementia or psychosis. Cognitive dysfunction, social isolation, and sensory deprivation are the main causes of this syndrome, although other diseases and toxins may also be involved.CBS is widely underdiagnosed, and multidisciplinary involvement from different specialists is necessary.Patients with this syndrome may experience fear. Psychological treatment and/or pharmacotherapy such as antipsychotics is recommended. In a patient presenting with hallucinations, a thorough examination and broad differential diagnosis must be performed to rule out any underlying neurological disorder.