Hearing/Vision connection

[LNN]

Trying to connect some dots here - but don't want to connect things that aren't connected.

My son's school called today - DS10 failed his hearing screening

• 
   
  
• In 1st grade, both ears failed only the 1000Hz tone. The pediatrician said to just watch it. (he was severe Pandas then)
  
• In 2nd grade, he passed his hearing screening all tones, both ears (recovering post-pex)
  
• In 3rd grade, both ears failed at 1000 Hz - couldn't hear at 20Db but could hear it at 25Db (had just started lyme treatment)
  
• In 4th grade, no screening
  
• In 5th grade (now), he failed his initial screening at 1000 hz but upon recheck, only the left ear failed, but left ear could hear this tone at 30Db
  

 

He doesn't seem to be in any sort of flare but is getting over a cold and complained of a sinus headache yesterday. In addition, he's just been diagnosed with convergence insufficiency - a vision issue akin to dyslexia - and for that, we've started doing some exercises that work on proprioceptive and hand/eye coordination.

 

In my brief googling, I came across the vestibular system and saw mention of a connection between sensorineural hearing loss and eye movements. I'm wondering if 1. these issues are connected and 2. if the exercises we're doing for vision therapy could help the vestibular issues and 3. if this is only a mild hearing loss that seems to come and go, is it even worth the expense (we are broke from vision therapy and lyme treatment) to see an audiologist and would he/she do anything? I can't run to yet another doctor and bleed more cash if it's for nothing.

 

Thanks for any input

[landamom]

LLM, I'm curious what abx your son is on or has been on? The reason I am asking is because my husband started on Doxy recently for myco p and possible Lyme. He has been experiencing hearing loss and apparently it can be associated with doxy use and the use of other "cyclines". Have no idea if this is the case with you, it's just something we have been dealing with and trying to figure out also so I thought I would let you know what we have found. Best of luck with this-

[LNN]

He's never taken a cycline - only has a few adult teeth, so Doxy isn't an option. I know certain anx can cause hearing loss and/or tinnitus - vancomycin being one of them. But nothing on the list I found has crossed our doorsteps.

 

He's taken augmentin, zith, omnicef, rifampin, bactrim and tindamax over the years but only zith/rifampin right now. He was on different abx each time he was screened. But thanks for bringing it up!

[EmilyK]

Trying to connect some dots here - but don't want to connect things that aren't connected.

My son's school called today - DS10 failed his hearing screening

• 
   
  
• In 1st grade, both ears failed only the 1000Hz tone. The pediatrician said to just watch it. (he was severe Pandas then)
  
• In 2nd grade, he passed his hearing screening all tones, both ears (recovering post-pex)
  
• In 3rd grade, both ears failed at 1000 Hz - couldn't hear at 20Db but could hear it at 25Db (had just started lyme treatment)
  
• In 4th grade, no screening
  
• In 5th grade (now), he failed his initial screening at 1000 hz but upon recheck, only the left ear failed, but left ear could hear this tone at 30Db
  

 

He doesn't seem to be in any sort of flare but is getting over a cold and complained of a sinus headache yesterday. In addition, he's just been diagnosed with convergence insufficiency - a vision issue akin to dyslexia - and for that, we've started doing some exercises that work on proprioceptive and hand/eye coordination.

 

In my brief googling, I came across the vestibular system and saw mention of a connection between sensorineural hearing loss and eye movements. I'm wondering if 1. these issues are connected and 2. if the exercises we're doing for vision therapy could help the vestibular issues and 3. if this is only a mild hearing loss that seems to come and go, is it even worth the expense (we are broke from vision therapy and lyme treatment) to see an audiologist and would he/she do anything? I can't run to yet another doctor and bleed more cash if it's for nothing.

 

Thanks for any input

Does convergence insufficiency cause letter reversals when reading?

[AmySLP]

Ok,

First thought is that he likely has fluid in his ears from cold/ congestion and hay combined with screening in a room not a sound proof booth, it's not surprising that he would not hear the tone until 25 or 30 dB. It's been more than 10 yrs. since I had to do an audio. Internship, but I think we accepted higher dB levels 20 or 25dB at higher frequencies in settings such as a school would use. Screening are just that -screenings. Usually done by a school nurse or assistant and there is room for error. Now that said, audio evals. By an audiologist are usually 100% covered for the audiogram. They usually do not cover hearing aids, but will cover testing. Be sure it's an audiologist if you choose this route, not a hearing aide dealer (although they will offer free hearing evals that you could pursue if your insurance doesn't cover). They can be gimmicky but may give you some insight if further testing by a real audiologist (M.S. or AuD degree) is necessary. Hearing loss that comes and goes is a conductive hearing loss from fluid, treated with tubes in younger kids if its chronic.not sure the the view on children his age. If his hearing loss is intermittent it's conductive and not sensorineural.

 

My daughter had been dx. With convergence insuff disorder at age 4, same age she was dx,. Pandas. She's outgrown it. Words and sentences jump around the page from what I was told, not reversals per say. Not sure about a correlation here with hearing.

 

Hope that helps...

 

Amy

[colleendonny]

I am curious about this as well. My DD5 Complains often that her eyes are blurry.... We have an eye doc appt. next week.

[LNN]

Amy - thanks for the help. Good to know that the setting could be part of the issue. I spoke with a friend whose son wears hearing aids, got the name of a good audiologist and will see if I can get in before the end of the yr. Otherwise, our huge deductible resets. DS sees his pediatrician for his annual physical next week and last time this cropped up, she was able to some brief eval with a wired device and gave us the all clear.

 

Colleen and Emily - here's a good summary on convergence insufficiency http://www.childrensvision.com/reading.htm While letter transposition isn't part of CI, my DS did have a number of errors when she tested for reversals. No only does he flip letters, he also flips words - so he doesn't see the difference between "the dog sat on the rug" and "the dog sat no the rug". He also has a major tracking issue, where his eyes bounce off the line he's reading and he's suddenly looking at a word on the line above or below - loses his place all the time and gets very frustrated. He also skips words - especially small words like the, he, they - while reading and writing. The therapy does seem to be helping.

 

Colleen - not all eye doctors test for or believe in treating convergence insufficiency. Don't totally understand the controversy, but you'd need to go to a behavioral optometrist for testing. My DD was diagnosed as having lazy eye by her pediatrician when she was 4. Lazy eye is absolutely part of convergence insufficiency. Yet the eye doctor we were referred to never addressed the lazy eye and only gave her glasses for far sightedness. She always said the glasses didn't help and now I know why - they weren't the right glasses. This new doctor gave her bifocals with part of the lens that bends light to help with the CI - and she wears her glasses all the time now, willingly. We found our doctor thru this site https://covdwp.memberpoint.com/WebPortal/BuyersGuide/ProfessionalSearch.aspx but there are other sites as well and I know of 2 doctors in my area who don't show up when I search this site. So you need to poke around a few different referral sites.

[JAG10]

Hi Laura,

 

My graduate students do a good bit of the hearing screenings in my elementary school because they need the hours. Once they get their 10 hours, the nurses do the rest. Amy is correct; it's just a screening. The conditions are horrible to screen hearing....between outdoor recess, lawn mowers, screaming kids, fans/heaters/blowers, ...it really is ridiculous. Passing at 25 or 30db would not concern me at all.

 

The colds definitely play a role as well. We had one kindergarten student who legitimately failed one ear (not related to inability to follow directions, distraction or otherwise confused.) Turned out she was on amox for an ear infection. Re-screened two weeks later and passed.

 

If you can get the audiologist covered and it gives you peace, go for it. That said, there's a good chance it is nothing.

 

Happy Thanksgiving friend! Jill

[kimballot]

 

In my brief googling, I came across the vestibular system and saw mention of a connection between sensorineural hearing loss and eye movements. I'm wondering if 1. these issues are connected and 2. if the exercises we're doing for vision therapy could help the vestibular issues and 3. if this is only a mild hearing loss that seems to come and go, is it even worth the expense (we are broke from vision therapy and lyme treatment) to see an audiologist and would he/she do anything? I can't run to yet another doctor and bleed more cash if it's for nothing.

 

Thanks for any input

 

I am not sure what you found with the connection between sensorineural hearing loss and eye movements. There is some connection, but I suspect it is primarily through the vestibular system. The 8th cranial nerve carries information from the vestibular system (inner ear/ semicircular canals and such), which tells us about head movement and our relationship to space, and also carries auditory information (from the chochlea). The information is from two different receptors and is actually carried in separate tracts, but it is in the same nerve geographically and the same sheath surrounds both tracts. Therefore, if you have damage to that nerve, you would have both hearing loss and vestibular dysfunction.

 

That being said, vestibular information is highly correlated with eye movements. That is why you can look at an object and turn your head to the right without your eyes moving from the object - your eyes actually move at the exact same rate as your head but in the opposite direction. It is a very finely tuned reflex that we use all the time.

 

Therefore, I think there is probably a strong connection between eye movements and vestibular - which may include the 8th cranial nerve. I do not think the connection between hearing and eye movements is as strong. I suspect that in many of our children, ALL sensory systems are out of whack so there is a correlation but not a causation between systems

 

Some folk put more stock in auditory processing as the root of all sensory problems than I - so take my opinion for what it is worth and I would certainly be willing to step back if someone has an article that counters what I have said.

 

I agree that the more likely culprit is fluid in the ears or something like that and I agree that a good audiology eval is in order.

[EmilyK]

No only does he flip letters, he also flips words - so he doesn't see the difference between "the dog sat on the rug" and "the dog sat no the rug". He also has a major tracking issue, where his eyes bounce off the line he's reading and he's suddenly looking at a word on the line above or below - loses his place all the time and gets very frustrated. He also skips words - especially small words like the, he, they - while reading and writing. The therapy does seem to be helping.

 

 

That sounds exactly like what happens to DS. I'll have to dig into that topic a bit more. thanks

[LNN]

Jill and Kimballot - thanks for the additional input. I've scheduled an appt with an audiologist in 2 weeks just to check it out once and for all. DS was initially against it - mom dragging him to yet another doc, after making him get glasses and do vision therapy. His friend wears hearing aids, so he was worried that would be the next apparatus I forced on him. But I've told him that's not going to happen. But since we've hit our deductible, it's worth checking out.

 

EmilyK - if you missed it, here's a link that explains CI pretty well http://www.childrensvision.com/reading.htm You'd need to see a behavioral optometrist, not a regular optometrist, for an evaluation. the site has a link to get referrals to docs in your area.

[EmilyK]

Got it - good read LLM