Looking Good – Sounding Better

We take our senses for granted but our ears and eyes are under constant threat. So what’s the best way to care for them? Victoria Lambert finds out… Although all of us dread going blind or deaf, few of us are proactive about protecting our eyes and ears; they’re easy parts of the body to neglect. Yet, research has shown – and doctors confirm – that with surprisingly little extra care it’s easy to improve your chances of retaining your senses, not to mention avoiding infections and irritations.

Indeed, new research has shown that our basic diet is as important as hygiene or health care: a recent study from Nigeria, published in the journal Otolaryngology: Head and Neck Surgery, linked low levels of folate or folic acid, a B vitamin, to hearing loss in the elderly.

Study author Akee Olawale Lasisi of the University of Ibadan explains: “Based on our research, age-related hearing loss may be associated with poor micro-nutrient status. The role of folate in cellular metabolism, the nervous system and vascular function is important for the auditory system.”

Previous studies have found that B vitamins may also help prevent age-related macular degeneration – the leading cause of blindness in people aged 65 and older – when a layer of the eye deteriorates, blurring the centre of the field of vision and making it difficult to recognise faces, read and drive. The 2009 study, conducted at the Brigham and Women’s Hospital  in Boston and published last year, found that women (although the results should apply equally to men) who took a combination of B vitamins – B-6, folic acid and B-12 – reduced their risk of macular degeneration by more than one-third after seven years compared to women taking dummy pills.

Dr William Christen, who carried out the survey, says it is too soon to suggest universal B vitamin supplements but recommends that people with the disease should talk to their doctors about over-the-counter supplements to help support the eyes. These contain vitamins C and E and zinc, which prior studies have shown help slow the disease.

Christen and others recommends food sources of B vitamins and folic acid such as meat, poultry, fortified cereals, beans, nuts, leafy vegetables, spinach and peas. Other research has linked supplements of a micro- nutrient called lutein and omega-3 fatty acids found in fish oils to healthier eyes (and reduced loss of sight).

Andrew McCombe, a consultant ear nose and throat surgeon at Frimley Park Hospital Surrey, and spokesman for head and neck surgery information service ENT-UK, suggests that if you want to keep your ears working well you should think about all three parts: the outer ear (which acts as a funnel for sound), the middle ear (which equalises pressure between outer and inner ears via the eustachian tubes), and the inner ear (where soundwaves are converted and sent to the brain for interpretation).

“You need to look after all the parts to protect your hearing,” he says. Firstly, he recommends that you leave ear wax alone: “It is a misconception that it needs to be cleaned out; it is a build-up of sebum secretions and old skin, and should naturally drop out.

“If you feel you must get it out, try sodium bicarbonate ear drops from a pharmacist to soften the wax (olive oil or hydrogen peroxide drops can work, too). Syringing by a doctor or nurse can be useful, but there is no need to go all the time and if you do have them sucked out once, it can be a one-off.”

Problems in the middle ear tend to be a feature of early childhood, says McCombe. “Some children find they don’t work too well; in this case, grommets can be placed in the ear drum where they help the flow of air and pressure, and help prevent ear infections.”

In adults, he warns, middle-ear infections can be caused by flying with a cold: “The ear will struggle to keep pressure equal which can cause bruising of the chamber, earache and fluid build-up leading to infection. If you have to fly with a cold, invest in a decongestant, and concentrate on sucking a sweet on descent as that’s when you really need to get the eustachian tubes open, as pressure is more difficult to stabilise.”

If you do get an earache, he recommends painkillers for 24 hours, but if that doesn’t settle down, head to the GP for antibiotics. The inner ears are more difficult to care for: “Try not to bang your head as injuries can damage your hearing and your balance permanently,” says McCombe. “Consider wearing a helmet when skiing or cycling for example. If you suffer an infection such as labyrinthitis, which will affect balance, there is nothing much you can do except wait for your body to recover from the virus. Take rest and plenty of fluids.

“Also be aware that this is a sensitive organ and if you listen to loud noises for protracted times, you can damage your hearing. Anything above 85 decibels (a busy street with traffic noise) for longer than eight hours will put you at risk, and the risk increases sharply so that at 94 decibels, you could suffer damage after just one hour.” He adds: “Rock concerts can be about 110 decibels, so you could think about using ear plugs – don’t be concerned about sound quality. Research shows that using an ear plug can help improve function so that your hearing of the music is better not worse.”

When it comes to eye care, Prof Dan Reinstein, lead surgeon at the London Vision Clinic, cautions against supplements which make claims about preserving sight: “People need to be cautious; far better to eat healthily and take in nutrients in food.”

Prof Reinstein says there are two key issues – smoking and screening. The latter is crucial and rarely undertaken after the age of 40, he says (only 30 per cent of the population wears glasses; the other 70 per cent don’t and therefore never visit an optician) – yet, you still need an eye test at least every two years.

“One of the leading causes of blindness is the disease glaucoma,” he explains, “yet you would never know you had it until it was advanced. Even the screening air-puff test is only 50 per cent effective.” In glaucoma, the optic nerve is damaged, leading to progressive, irreversible loss of vision. It is often, but not always, associated with increased pressure of the fluid in the eye. “If we catch it early, we can treat it with drops and surgery, but any damage to the optic nerve is permanent so we can’t reverse it.”

“The real problem is macular degeneration,” Prof Reinstein says, “and the overwhelming way to avoid that is not to smoke cigarettes. Everyone has a high risk of developing macular degeneration – between 65 and 75, 15 per cent of the population will have it – a figure which rises to 30 per cent after 75. But if you smoke, your risk is double – I think a one in three chance of blindness is actually a much stronger reason to quit even than lung cancer.”

Smoking is so dangerous to sight because, think researchers, certain chemicals in cigarette smoke may disrupt blood flow to the retina, resulting in damage. These chemicals may also alter nutrients in the blood called antioxidants, which are thought to protect the macula against damage. “The good news is that whenever you quit your chances of blindness start to diminish,” adds Prof Reinstein.