Glasses and hearing aids together: making them get on

Behind the ear there is barely more than a centimetre of room. That is where the arm of your glasses wants to sit, and that is where the hearing aid wants to sit. When nobody has thought about the two devices at once, you notice it on day one: the arm lifts the hearing aid, the hearing aid whistles when you put your glasses on, and one of the two ends up on the floor every time you take your glasses off to read.

It is not a fault of the hearing aid, nor of the frame. It is a problem of order: they are almost always bought in different places, months apart, and without anyone measuring the gap that will be left.

Why they get in each other’s way

Behind-the-ear and RIC hearing aids rest their body in the groove between the ear and the skull. The arm of your glasses rests in that same groove. If the arm is thick, it pushes the hearing aid outwards and lifts it off the skin. With the hearing aid lifted, two things happen.

The first is that it moves. It stops sitting the same way, the tube or the wire pulls on the mould, and the sound changes from one moment to the next without you having touched anything.

The second is the whistle. Acoustic feedback appears when amplified sound escapes from the canal and goes back into the microphone. A wide arm pressed against the hearing aid’s microphone acts as a wall: it bounces the sound back. Many people believe the hearing aid “has broken” when the only thing that has changed is that they are wearing different glasses that day.

There is a third detail that only shows up with use. The bend of the arm, the curve that drops behind the ear, is what catches the hearing aid when you pull your glasses off in one movement. Hearing aids that fall on the floor almost never fall while you are walking down the street. They fall in the act of taking your glasses off.

The decision almost nobody makes in time

Choosing the frame and the hearing aid on the same day, with the same person in front of you.

It sounds obvious and it is remarkably rare. What normally happens is that hearing aids are bought at a hearing centre, glasses at an optician’s, and the incompatibility is discovered at home. When both are fitted under the same roof, the conversation changes: first we measure what style of hearing aid your hearing loss needs, and then we look for the frame that fits alongside it. Or the other way round, if you already have a frame you have no intention of giving up.

This is, honestly, the only point in this article we could not put our name to if MODALENT did not have the audiology room and the optometry room in the same premises. Everything else you can read anywhere. This you cannot.

What to ask for in a frame

• A slim arm. Titanium allows thicknesses that acetate cannot reach without snapping. A narrow titanium arm leaves the hearing aid its space and weighs little on the bridge of the nose, which is the other thing that starts to suffer after sixty.
• A straight arm, or a gentle curve. The less of a hook there is at the end of the arm, the less chance of tangling it with the hearing aid as you take your glasses off.
• A flexible tip. The end of the arm must be adjustable with heat without changing the height at which it rests. That is where the millimetre that decides everything is won or lost.
• A hinge without a bulky spring. The spring sits exactly in the area that rubs against the hearing aid’s microphone.
• Avoid paddle arms. Wide arms, very fashionable on sunglasses, are the worst possible companion for a behind-the-ear aid.
• Weight spread evenly. If the frame is heavy, you will reposition it fifty times a day, and every adjustment moves the hearing aid.

Which style of hearing aid makes it easier

The RIC is the most widely used style today and the most compatible: the body that sits behind the ear is narrow because the receiver is inside the canal, not in the casing. With a slim arm, both fit without touching.

The classic behind-the-ear (BTE) is bulkier because it houses the whole amplifier. In exchange it gives more power and copes better with earwax and moisture, as the American national institute for deafness and communication disorders notes. If your hearing loss calls for that power, the frame will have to adapt to it and not the other way round.

In-the-ear styles (ITE, ITC, CIC) solve the conflict by elimination: there is nothing behind the ear. But it is worth knowing what you give up along the way. They are harder to handle with your fingers, they have less room for the battery and the controls, they do not always come in a rechargeable version, and they are more exposed to earwax and to moisture in the canal. The same body warns that they can be difficult to put in and take out. If you have arthritis in your hands or poor close vision without glasses, and you are going to handle the hearing aid precisely when you are not wearing your glasses, that detail weighs more than it seems.

The right order

It is a small thing that changes the whole day.

1. To put on: hearing aids first, then glasses.
2. To take off: glasses first, then hearing aids.

Glasses go on and come off many more times a day than hearing aids do. If the hearing aid is already in place and settled, the arm slides over the top without dragging it. Do it the other way round and every time you put your glasses on you will be repositioning the hearing aid as well.

And take your glasses off with both hands, holding both arms at once. The one-handed tug is what sends hearing aids to the floor.

What to ask your optometrist for

If you already wear hearing aids, say so before anyone takes a single measurement. There are three specific things to ask for:

• That the frame is adjusted with the hearing aids in. Not afterwards, not “you’ll get used to it at home”. With the devices in place, in front of the mirror, checking that the arm does not shift them.
• That the fitting height for progressive lenses is taken with the hearing aids in. Hearing aids subtly change how the frame rests. A couple of millimetres’ difference in the height of a progressive lens translates into having to lift your chin to read.
• That someone looks at your ear canal. A wax plug gives no symptoms until it gives all of them at once: the hearing aid whistles, you hear less, and nobody knows why.

Sunglasses count too

On the Costa Cálida, sunglasses are not an August accessory: they are worn from February to November. And they are usually the model with the thickest arms in the wardrobe. If you wear hearing aids, choose your sunglasses with the same criteria as your prescription pair, and try them on with the devices in before you pay for them.

The same goes for swimming goggles, for a cap and for a mask at the doctor’s surgery. Everything that passes behind the ear is competing for the same centimetre.

When to have it looked at again

The ear does not change, but the frame does. Arms open out with use, tips lose the shape they were given with heat, and the nose gives way. After a few months, glasses that used to live happily alongside the hearing aids have started pushing them without your noticing, because the change has been a millimetre a week.

If lately one hearing aid whistles with your glasses on and not without them, or if you notice you hear differently depending on which glasses you are wearing, it is not your imagination. It is geometry, and it is sorted out in one visit.

In Puerto de Mazarrón you can bring us the glasses and hearing aids you already have, wherever they came from, and see them together in the same chair. It takes half an hour and there is nothing to buy.