All About Your Eyes and Ears

Here, what you need to know to keep your eyes and ears healthy

Good vibrations

Plink. Plink. Plink.

“Can you hear that?” Kelly Dickson, 52, laughs and assures her son, eight-year-old Christopher, that she’s heard all the little noises he’s making in their kitchen. “Wow, you have magic hearing,” he says. He’s almost right, except it’s technology, not magic that’s boosting Dickson’s hearing.

Chronic ear infections had tormented her since at least the age of four. After 13 sets of tubes in each ear and unsuccessful tympanoplasties (ear drum replacements), Dickson began using hearing aids six years ago. A nephrology nurse in a dialysis unit, she often removed them to use an amplified stethoscope, increasing risk of ear canal infection. “The longer I’ve been wearing [the aids],” she says, “the more ear infections I’ve been getting. I have no more eardrum left because of them.”

Then last April, Dickson became the first in North America to receive a Bonebridge transcutaneous bone conduction implant, a two-part hearing device. An outer component hidden by her hair picks up sound waves and changes them to signals, which it sends to an embedded implant. (It clips to the implant with a magnet and can be replaced as technology advances. A fine wire tethers it to her hair in case it is bumped out of place.) The implant changes the signals it receives to vibrations that travel through the bone of her skull to the inner ear. Here they are converted to electrical impulses the auditory nerve picks up and sends to the brain, as happens in natural hearing.

After a CT scan to check bone thickness in Dickson’s skull, Dr. Sumit Agrawal, a head and neck surgeon and assistant professor in the department of otolaryngology at the London Health Sciences Centre (LHSC), made a three-centimetre incision, drilled a precise well and secured the implant flush with the bone. It healed within two weeks.

Most of Agrawal’s patients are helped by hearing aids. Some, whose inner ear doesn’t work, need a cochlear implant. The Bonebridge device helps people like Dickson whose inner ear works but who face problems with the external and/or middle ear. “The Bonebridge directly stimulates the inner ear and avoids a metal abutment coming through the skin – the huge advantage of this technology,” he says.

Kim Zimmerman, an audiologist at the LHSC, points out the system takes advantage of Dickson’s natural hearing, although signals reach the
inner ear through a different process than occurs normally. Dickson’s audio processor was placed over her internal component, and adjustments made using dedicated software. “After the initial fitting is completed, follow-up is fairly minimal,” Zimmerman says.

About three weeks after the surgery, Dickson took out her hearing aids and immediately had trouble hearing. Then she snapped on the audio processor. “I could hear,” she says, still in awe. “It blew me away.” Zimmerman helped her adjust volume and fixed some distortion, then Dickson headed off to a world transformed. Outside, a car starting in the parking lot brought her to tears.

“With a range of hearing losses throughout the years, you don’t notice what you’re missing. It gets worse and worse, so you forget. When you hear something new, it’s exciting,” she says. Now she hears co-workers calling or alarms going off behind her, parts of a nurse’s routine she had sometimes missed.

Perhaps the most meaningful changes for her happen at home.

“When I left for work the other day, my husband was standing [behind] the glass door. I was halfway down the walkway, when he said, “I love you. Have a good day.” To his delight, Dickson recalls with a huge smile, “I turned around and said, “I love you, too.” Only weeks earlier, she wouldn’t have heard him. —Jayne MacAulay

HEAR YE

People with hearing loss related to external or middle ear problems may be suitable candidates for the Vibrant Soundbridge implant system. The implant, placed under the scalp, receives electric signals from an outer audio processor held over it by magnetic force. The outer unit converts sound waves to electrical signals that the implant sends to a tiny unit fastened to the middle ear. The unit vibrates, which the brain interprets as sound. (This system isn’t affected by skull growth and has been approved in Canada for children 10 and older.) For information on this and the Bonebridge systems, go to www.medel.com.  —JMac

twosense_visionquestVision quest
Hugh Montgomery, 55, will likely never forget the first time he tried on eSight eyewear. “It was incredible,” he says. “My vision went from legally blind to 20/40. Kate, my daughter, was with me, and I could see her facial expressions from across the room.”

The new device, launched last year by Ottawa-based eSight Corp., allows Montgomery, a consultant to the company, to read the newspaper, use the computer easily and see out the window – tasks he had trouble with since the mid-1980s when he developed Stargardt disease, a genetic disorder that causes degeneration of a small area of the retina (called the macula), responsible for sharp central vision.

Besides making a difference for those with Stargardt disease, eSight can bring better vision to a range of other legally blind people with conditions like macular degeneration, diabetic retinopathy and certain (not all) forms of glaucoma.

The device looks like a bulky pair of sunglasses. It works by projecting magnified images of what the user is looking at onto LED screens inside the glasses. Unlike other vision aids, it’s used both for looking across a room and for reading papers right in front of you. Features like automatic focus, adjustable contrast and brightness, different colour modes and custom-made prescription lenses make it highly personalized.

The entrepreneur behind the invention, Conrad Lewis, has two sisters with Stargardt disease. “I was really charmed by Conrad’s sincerity and his goal to aid people,” says Dr. John Granda, an optometrist and vision performance expert who consulted on the project. “When you watch people put it on for the first time, you don’t hear, ‘I can see smaller print,’” Granda says. “It’s, ‘I’m now connected with my world.’ You see the tears, you see the ‘wow.’ When you really see the person get tugged from their inner core – that’s the part that makes me happy as a professional.”

The device isn’t cheap, starting at $9,750, but that includes training and 24-hour support. It best suits people whose visual acuity is between 20/60 and 20/400 and who have some peripheral vision. Go to www.esighteyewear.com or call 1-855-837-4448 for an assessment.  —Lisa Bendall

Sight Scene

Pedalling up a road, you wonder how far to the next stop. A glance through the bottom of your Dual Power Eyewear sunglasses brings your GPS or cellphone into focus and, whew, a breather is around the corner. The stylish wraparound glasses hide a bifocal bottom that lets you check a cellphone or even your car’s dashboard without switching to reading glasses. Available in +1.5, +2.0 and +2.5 viewing powers, they’re so lightweight and comfortable you’ll probably wear them whenever you need sunglasses. They come in several cool styles, some with clear or amber accessory lenses. www.dualeyewear.com  —JMac

Anti-Cataracts
Want to fight off cataracts? Stick to a diet that’s rich in antioxidants. A large-scale Swedish study examined the eating habits of more than 30,000 women over age 49. They found that those with the most antioxidants in their diets – whether from fruits and veggies, whole grains, even coffee – were least likely to develop cataracts over a seven-year period.

Cataracts are an inevitable part of getting older, as the lens of your eye hardens with age. Cataracts don’t hurt, but it’s a pain all the same when they cloud and distort vision. They often start developing in our 50s, and half of us have them by 65.

“We’re seeing cataracts at a younger age,” says Dr. Rosa Braga-Mele, director of cataract surgery at Toronto’s Kensington Eye Institute and a member of the Canadian Ophthalmological Society. This may partly be because, compared to their parents, baby boomers are less likely to suffer the vision problems in silence. “They’re coming to us sooner, wanting something to be done about it.”

Cataracts can’t be prevented. But you can slow down their progression. Of course, there’s not much you can do about a family history – if your parents got cataracts early, you may be destined to follow in their footsteps – and certain medications, like steroids, also raise your risk. But you can reach for your Ray-Bans. Limiting your exposure to sunlight will delay cataracts. So will choosing not to smoke, managing your weight and looking after your general health – for instance, keeping diabetes well controlled.

With this Swedish research, it’s encouraging to know that pouring a second cup of coffee, piling veggies on your dinner plate or taking other steps to raise your antioxidant intake is another way we might slow down cataracts.

If you’re already detecting symptoms, don’t fret. “Cataracts nowadays are very easily treated. Surgery is patient-friendly, and outcomes are very good,” says Braga-Mele. Don’t wait to see an ophthalmologist, she adds. “When vision starts to bother you, it’s treatable.”  —LB

Sight lines
Bono’s shades aren’t rock star vanity – the glasses help protect his light-sensitive eyes, as do Vogue Editor Anna Wintour’s. Exposure to ultra-violet rays put aging eyes at risk of developing cataracts and age-related macular degeneration (AMD), conditions that can severely compromise eyesight. (The U2 singer is 54 and Wintour is 64.) You can’t dodge advancing age, a family history of AMD and race (Caucasians are more susceptible to macular degeneration) but you can lower risk by not smoking, controlling blood pressure and eating plenty of green leafy veggies like kale and spinach that contain the antioxidants lutein and zeaxanthin.

An Age-Related Eye Disease Study (AREDS) concluded that people with intermediate AMD could lower risk of progressing to the vision-blocking advanced stage by 25 per cent over the five-year study by taking a high dose of antioxidants (vitamins C, E, beta carotene) with zinc, and eating more foods with lutein and zeaxanthin. The recent AREDS2 follow-up study, however, eliminated beta carotene because it seemed to increase risk of lung cancer in smokers and instead added lutein and zeaxanthin to the formulation. Omega-3 supplementation didn’t appear to slow the march to advanced AMD. Unfortunately, the AREDS2 formula doesn’t prevent cataract. The Canadian Association of Optometrists recommends a biannual eye examination for people aged 19 to 64 and a yearly exam for those 65 and older. Try Shoppers Drug Mart Life Brand iCare Plus, Adult 50+ Eye Vitamin and Mineral with Omega-3 Formula, $18  —JMac