Lack of association between hearing loss and glaucoma

Some studies have suggested a relationship between glaucoma and sensorineural hearing loss. Others have found no evidence for an association. We performed a study to determine whether there is a significant difference in hearing between patients with glaucoma and a matched control population. Patients presenting themselves to a glaucoma clinic were grouped by type of glaucoma: uveitis, primary open-angle, pigmentary, pigmentary dispersion, congenital, or ocular hypertension. Patients older than 60 were excluded from the study, as were those who met certain carefully chosen exclusion criteria. Subjects included 40 men and 27 women, ranging in age from 15 to 60 years. Glaucoma was bilateral in all cases. Auditory thresholds at 0.5, 1.0, 2.0, and 3.0 kHz were measured bilaterally and statistically compared with American National Standards Institute (ANSI) normative values. Speech reception threshold and intelligibility were also assessed. When compared with speech ANSI values, there were no significant differences in mean thresholds at any frequency for any of the glaucoma types. Mean speech reception thresholds and intelligibility scores were all within normal limits and no subjects showed evidence of sensorineural hearing loss greater than expected for age. There were no differences between glaucoma groups, and we found no evidence of an association between glaucoma and hearing loss. There is disagreement about whether or not an association exists between glaucoma and hearing loss. Among those who do feel there is a relation, there is wide disagreement about what proportion of glaucomatous patients have a hearing loss. Rampoldi (1) first described an association between glaucoma and inner ear disease in 1889. Since that time, a number of reports have suggested such an association (2-4; 6-12). However, many of these studies are methodologically flawed. A few studies found no evidence of a relationship between glaucoma and sensorineural hearing loss (14, 15). There have been few reports since the 1970s, and the question remains unresolved. If there is, in fact, a relationship between glaucoma and inner ear disease, potentially much could be learned about certain forms of hearing loss from the study of glaucoma. In particular, surgical specimens (trabecular meshwork) could be obtained in those patients who undergo operations for their glaucoma. This tissue could be examined using current histopathological techniques. On the basis of the results, hypotheses might be made, by inference about which pathological processes are manifested in the inner ear. Therefore, we performed a study to evaluate whether there is a significant difference in hearing between patients with glaucoma and a matched control population.