6 Tuesday March 15 2022 | the timeshealth
Despite
years at
concerts
I’ve never
undergone
a hearing
test
implications of hearing loss are even
more serious than sight loss.
According to WHO statistics,
almost 50 per cent of teenagers and
young adults aged 12 to 35 are at risk
of hearing impairment as a result of
exposure to loud music on
smartphones or powerful modern
PA systems. In older people hearing
impairment can be a factor in social
isolation and contribute to the onset
of dementia.
And yet, despite many years at rock
concerts and listening to Spotify on
powerful headphones, I have never
undergone a hearing test.
My first test is on the Royal
National Institute For the Deaf
(RNID) website. You find a quiet spot
and take its “noise and digit” test. A
woman reads a series of three digits
numbers in what sounds like the hiss
and static of a torrential downpour.
You type the numbers you hear into
a keypad.
With each round, the background
noise becomes louder and her voice
less distinct. By the end I was craning
into my phone speaker like a member
of the resistance straining to hear a
crucial radio message. Unsurprisingly,
after three minutes of this, I received
the gloomy information: “Your results
suggest you may have hearing loss.”
Officially the RNID suggests I see
an audiologist, but first I decide to try
the Mimi hearing test app. After
downloading it onto my smartphone I
am offered two assessments: the
quietest sound I can hear at four
different frequencies (between 500Hz
and 4KHz) and the quietest sound I
can hear in a noisy environment.
The results were then collated and
measured against WHO guidelines
for normal hearing.
I found the tests, one for each ear, a
bit fiddly, but at the end the app
produced an audiogram for me. The
hearing loss, although not great, was
slightly worse in my left ear than my
right. That baffled me. I put it down to
20 years of children nagging me aboutpocket money and me learning not to
listen to what they are saying from the
passenger seat of my car.
Jesal Vishnuram, the technology
adviser to the RNID, says that while
adults ought to think about testing
their hearing regularly from about the
age of 45, youngsters are beginning to
show more awareness of the noisy
world they inhabit.
“Even the electronics giant Apple is
itself conducting the Apple Hearing
Study, collecting data directly from its
millions of smartphone users,” she says.
According to Apple’s hearing tests,
20 per cent of participants have
experienced hearing loss by WHO
standards. “The odd thing is while eye
tests and dental check-ups are taken
seriously, going to an audiologist is
not,” Vishnuram says. “An app can be
a useful starting point but you really
need a professional examination too.”
Although often overlooked,
audiology tests are free on the NHS,
as are a range of hi-tech hearing aids
often enabled with Bluetooth (they
allow wearers to stream music,
podcasts and television sound straight
from a smartphone).
“The world has never been
noisier, especially for young people
exposed to high decibel sounds
through headphones on a daily basis,”
Vishnuram says. “My advice is:
take your hearing as seriously as
your eyesight.”
The idea that a smartphone can
offer immediate triage on a number of
medical conditions can be addictive.
After testing sight and hearing I found
myself exploring an app called Elbow
Decide that diagnoses common elbow
ailments in 3-D.
According to Nature there are more
than 350,000 e-health apps on the
market, with about 200 new ones
published each day.
“They can be a starting point,” Gow
says. “But when it comes to proper
diagnosis, a professional with all the
equipment, lateral thinking and
intuition they bring is still the best.”I
t has become fashionable to
suspect that your smartphone is
listening to, or even watching,
everything you do. Now it seems
your device can keep a close eye
on things, but perhaps in a way
for which we should be grateful.
The launch of e-health
smartphone apps such as
MyReaderNumber or Mimi, which,
respectively, can assess your eyesight
and your hearing, take the idea of
intrusive tech and flip it on its head.
I have been short-sighted since I was- For years I have regularly attended
optician appointments, taking
increasingly wild stabs at the letters on
a Snellen chart (the board of alphabet
letters used since 1862).
Ophthalmic assessment tools have
become a bit more sophisticated since
then, such as that annoying puff of air
the optician blows into my eye to
measure my IOC (intraocular
pressure, a metric for measuring the
risk of glaucoma).
During my last eye test I paid £10
extra for an Optical Coherence
Tomography scan. This takes detailed
pictures of the rear of the eye, which
can be used to spot early signs of
diabetes, macular degeneration and
multiple sclerosis.
Yet do I still need to go all the way
to an optician? MyReaderNumber, a
recently published app, makes it
possible to assess eyesight using just a
smartphone. It’s simple. You pay £2.49
to download the app (you will need an
iPhone 11 or later) and then create an
account. After that you answer a few
basic questions and take the tests.
There are two. The first is for your
near-distance reading prescription
(a book, for example). Take your
smartphone away from your eyes until
you can comfortably read some text
on the screen, then press the
“measure” tab in much the same way
you’d take a selfie. There is a second
measurement to establish your
mid-distance sight, eg reading a
computer screen.
For most people the
MyReaderNumber prescription you
receive at the end of the process is at
least good enough for buying reading
glasses at a pharmacy. I could use it to
order lenses online. After answering
an online questionnaire from a
company called Lensology I was
offered a pair of varifocal lenses for
£48.25 (they cost me more than £100
at Specsavers).
There are other self-test visual
acuity apps with more functions too.
Verana Health’s vision test app is free
and comes with an added function: an
Amsler grid that can help detect signs
of macular degeneration (the macula
is the central part of the retina
responsible for central, colour and
detailed vision). Staring at a dot in the
centre of the Amsler grid, seeing any
or missing or distorted squares might
suggest I had a problem.
I came through that test with flying
colours. No, not actual flying colours.
Floaters and flashes can be a sign of
retinal detachment, which is also a
very serious problem.
So should I really be entrusting my
eyesight to a smartphone app? In 2019
the journal Nature reviewed 42 “visual
acuity” apps and found that, although
they displayed “potential”, the overall
verdict was quite muted.
“The validity and reliability has not
been established,” the journal
harrumphed, although there is surely
a place for them where proper
ophthalmic care is hard to find. In
2013 Andrew Bastawrous, a British
former NHS ophthalmologist,
developed Peek (portable eye
examination kit), another smartphone
eye-test app, and trialled it in Kenya.
Since then it has helped thousands
of people in Kenya, Botswana,
Tanzania and India who might
otherwise have gone blind to find their
way to better care. The World Health
Organization (WHO) estimates there
are a billion people worldwide with
preventable vision impairment.
Louise Gow is a doctor of optometry
and specialist lead for eye health at the
Royal National Institute of Blind
People. For those of us lucky enough
to have access to proper ophthalmic
care, she thinks an eye test once every
two years is in order.
“Fifty per cent of eyesight loss is
avoidable, so if a smartphone app
makes you take an interest, fine,’’ Gow
says. “But these tests cannot replace a
proper eye test, which will not only
assess visual acuity but can also offer
early warning signs of high blood
pressure, glaucoma, diabetes, multiple
sclerosis, even strokes.”
The pandemic has been bad for our
eyes. Working via Zoom and endless
“doomscrolling” on smartphones has
been a huge challenge for our eyeballs.
“While there is no evidence screen
light impairs vision permanently, we
know that the blue screen light can
disrupt sleep patterns and cause digital
eye strain,” Gow says. “The latter isn’t
permanent but leads to tired eyes,
reduced blink rate and dry eyes. The
rule for any sort of screen time is
20/20/20. Every 20 minutes look away
from your screen for 20 seconds,
preferably extending your gaze for 20
yards. The other things known to
damage eyesight are smoking and
doing DIY without adequate eye
protection, both of which were quite
popular during the pandemic too.”
With your eyesight sorted you can
also use your smartphone to self-test
for hearing impairment. This is
important since, in many ways, theNeed an eye
test or worried
you’re going
deaf? There’s
an app for that
Concerned that his sight was
getting worse and people weren’t
speaking up, Michael Odell got
out his phone for a DIY check-up
GETTY IMAGES