As I have said before, I love my job. I get to see some really amazing things, and last week brought another one of those “Wow” moments. Ron and I were working with a patient in his 40s, Jim, whom we began treating about a year ago. He is a filmmaker who lives in New York, spends much time abroad and sees us during his infrequent visits to his Nebraska residing family.
Last year during his visit, Ron began to assess and discuss the role the partial hearing loss in his left ear might play in how his body responds to gravity and the space around him. Jim developed this loss as a young boy but it was never significant enough that it seemed to impair him. After his last visit with us, following Ron’s recommendations, he worked with his ENT father and an audiologist to obtain a hearing aid. No adjustments or modifications had been done since he received it due to this being his first time back in Nebraska since then.
As we went through the process of looking at clarity of vision, muscle tone in Jim’s body with differing lens combinations on, and his ability to center (shift center of gravity and balance without too much extension tone in the neck and back) over each leg, it became apparent that there was something not quite making sense. Jim’s body was not reacting at all the same as at the previous visit; it also appeared that he wasn’t doing as well as he should have been. Something had dramatically changed.
Hearing gives us auditory cues about where things are around us, just as vision gives us visual cues about the same things. Jim spent most of his life with better hearing in the right ear than the left. He had made adjustments and compensations for this, as anyone would. These patterns of processing auditory information in the brain are linked neurologically with the patterns of processing visual information in the brain. Change one, you will change the other.
And that’s exactly what we saw. Jim’s body reacted differently to the space around him with the hearing aid in vs out. His ability to center, muscle tone, posture, and most surprisingly, his subjective refraction changed as well! I had refracted (determined what prescription he wanted to see most clearly by playing the “Which is better?” game) him with the hearing aid in, and when he took it out his vision blurred with the same lenses in place. Wow.
So, which sense is the winner? We know from neuroscience that visual processing has more area in the brain than auditory; however, a lot more research has been dedicated to visual processing than auditory. There are many parallels between visual and auditory processing (you can read more about this in Lenny Press’s book, available at oepf.org). I don’t know that one will always trump the other. I do know that both play an important role, and the information processing from both systems has to “match” in the brain for the most efficient and accurate decision-making. This is another example of the need for professions to integrate to truly care for the whole patient and maximize the outcomes possible from any profession’s intervention.
Keep moving beyond sight!