Why hearing aids ≠ glasses

May 14, 2019

I understand why people often compare hearing aids to glasses. After all, they are both worn on the head and each helps to compensate for a sensory loss by improving the flow of signals to the brain. While I find the comparison helpful in battling the hearing aid stigma (e.g. glasses are socially acceptable, so hearing aids should be, also), the two have less in common than meets the eye—or ear.

When fit with a new pair of glasses, it is expected that eyesight will be corrected to 20/20 vision. With most vision losses this is possible, and eyeglasses or contact lenses make everything crisper and clearer. That’s because glasses and contact lenses actually correct blurry vision by bending light waves as they enter your eyes. By improving the signal through the lenses and delivering this improved signal to a fully functioning visual system, the result is fully corrected vision.

So, many might think that when they’re fit with a pair of hearing aids, they will likewise regain 100 percent of their lost hearing. Unfortunately, that’s not usually how it works for several reasons.

Vision problems tend to be mechanical in nature, while most hearing problems are nerve-related. This is why in most cases we can “correct” vision, but we “treat” hearing loss.

Types of hearing loss

The ear is made up of three parts- the outer, middle, and inner ear. Conductive hearing loss occurs when something is disrupting the transmission of sound from the outer or middle ear to the inner ear – it could be fluid in the middle ear, a perforation of the eardrum, or anything else that inhibits the flow of sound through the ear canal to the inner ear. Because this type of hearing loss typically occurs in the middle ear, there is no damage to the inner ear anatomy or auditory nerve.

Conductive hearing loss can sometimes be fully corrected through medical intervention (e.g. repairing a damaged eardrum, removing a blockage, or through medication). For conductive hearing losses that cannot be resolved medically, hearing aids can be a great solution. By amplifying the sound, it can more easily pass through the middle ear and be processed by the normal-functioning inner ear, leading to significantly-improved, distortion-free hearing.

Sensorineural, or nerve-related hearing loss, is much more common, accounting for 90% of the hearing losses in the United States.1 It is the result of damage to the inner ear most often caused by noise exposure, the natural aging process, or both. Hair cells within the inner ear that transmit sound to the auditory nerve cannot be repaired and are non-regenerative – in other words, the body won’t produce new ones to replace the damaged cells.

A unique characteristic to sensorineural hearing loss that is not the case for conductive hearing loss is that sensorineural hearing loss is accompanied by distortion in the auditory system.

Many people with sensorineural hearing loss say they can hear voices, but cannot understand what is being said. Even hearing aids, which amplify the sound and make things more audible, cannot resolve the clarity piece because of the inherent distortion in the auditory system.

Hearing and the brain

While correction of vision with glasses happens immediately, treating sensorineural hearing loss is more of a multi-step journey. A hearing care professional (HCP) can recommend the use of hearing aids to reintroduce sound to the patient, often for the first time in years. Hearing loss for most people occurs gradually over time, and this gradual change can be undetected by the individual with hearing loss until it reaches a certain level of severity.

Therefore, introducing new sound through a hearing aid can take some adjustment. It takes the brain some time to get used to these new sounds and learn what sounds to tune out and what sounds to pay attention to.

New hearing aid users often say they hear a clock tick in their home or their car’s blinker for the first time, for example. The hearing aid user needs to learn the sounds he or she has been missing, which is an exciting and sometimes overwhelming process.

Our brains are amazing – they adapt and learn quickly.

More than ever before, hearing aids are designed to make this adjustment process easier. Hearing aids now have settings and programming specifically designed for new hearing aid users. It is the goal of hearing aid manufacturers to make the introduction to hearing aids pleasant, making the sound as comfortable and natural as possible. The first fit of a hearing aid is a pivotal moment, since new hearing aid users have to find the first fit comfortable to become long-term hearing aid users.

The Value of Hearing

People tend to undervalue the importance of hearing and write hearing loss off as an inevitability of getting older. Or, people are very reluctant to get hearing aids due to a social stigma that does not exist with eyeglasses. For example, eyeglasses are now fashionably called “eye wear,” but no one refers to hearing aids as “ear wear.”

It is important, however, not to undervalue the importance of hearing, since more and more research articles are showing the importance of hearing on overall well-being. Connections between hearing and cognition, social-emotional aspects of life, and physical well-being are becoming stronger and stronger. Hearing is not just about hearing more sound. Hearing is truly a gateway to wellness.

Don’t let hearing loss hold you back

Going in to a first hearing aid appointment with an HCP requires realistic expectations and understanding of what hearing aids can provide. Hearing aids may not be able to immediately restore 100 percent of lost hearing, but the difference they have on the typical patient’s everyday life is dramatic. At follow-up appointments, many new wearers tell their HCP’s, “I couldn’t function without my hearing aids!”

Hearing is essential to communication, and communicating is essential to maintaining relationships with family, friends and colleagues. As Helen Keller famously said, “Blindness cuts us off from things, but deafness cuts us off from people.”


  1. Common causes of Sensorineural Hearing Loss. Healthy Hearing.

Lori Rakita, Senior Manager of Clinical Research at Phonak Audiology Research Center (PARC)

Dr. Lori Rakita is the Senior Manager of Clinical Research at the Phonak Audiology Research Center (PARC), in Warrenville, IL. As a clinical researcher, she designs and administers research studies in both lab and real-world environments with the goal of achieving better patient outcomes.

Prior to joining Phonak, Lori practiced at a neurotology clinic in Florida, where she worked closely with adults going through the cochlear implant process.  Before that, she spent several years at the Richard Davidson’s Lab for Affective Neuroscience at the University of Wisconsin.

Lori’s passion for investigating how hearing loss affects family dynamics, personal motivations and self-perception stems from her background in both psychology and audiology. Her current research examines the topic of hearing loss and emotions.

Lori received her Bachelor of Science Degree in Psychology from the University of Wisconsin-Madison and her Doctorate of Audiology from Washington University in St. Louis, MO.