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Our panel of doctors offers advice and suggestions to queries from readers.
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Can't hear
Deepak Das:
I am 58 years old and suffering from Otosclerosis Bilateral. Stapedectomy Right was done in 1982, and I have been hearing normally with my right ear. There has been a sudden loss of hearing with my right ear along with tinnitus from June 13, 2002. I was prescribed medication Fexofenadine Hydrocloride120mg OD and Neurobion Forte OD. Based on the audiogram, I have been advised to use a hearing aid. My doctor also asked me to continue with the medication for another five weeks, in case the loss of hearing is due to the nerves. My hearing with my right ear, has improved, marginally. I have also observed that noise in the right ear halts momentarily from time to time. Is there are any medical or surgical considerations. Please also let me know the cause and cure for tinnitus and auto-immune loss of hearing.
Dr. H. Ganapati, ENT Surgeon, replies:
You have developed sudden hearing loss 21 years after stapedectomy. This could have been due to a sudden rupture of the membrane that covers the hole that was made during the operation. This can result in nerve deafness. The other possibility is that the piston could have slipped from its position due to the loss of support to it following pressure necrosis of the anchoring bone, namely the incus. In this case, your conducting mechanism in the middle ear would have been affected. The latter hearing loss can be rectified by revision surgery though the risk is greater. In the former case, there are no remedial measures. There is no medicine to cure your current problem. Since you have hearing loss in both ears, you need a hearing aid to improve your quality of life. Medication can prevent further progression of otosclerosis but it will not improve your hearing.
Regarding tinnitus (abnormal sound in the ear) there is no specific treatment. Any disorder in the ear can cause tinnitus. If the cause is treated before the tinnitus leaves a permanent impression in the brain there is some hope of relief. Tinnitus retraining therapy is being tried. Autoimmune disease is a condition in which an individual's immune system reacts abnormally to his/her own body tissues resulting in cell damage. There can be many precipitating factors, which can trigger off an autoimmune reaction in an individual. There is no cure for it though it can be controlled by medicines. If the hearing loss is due to an autoimmune problem it can be treated using medication.
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D.S. Satyanarayana, Vishakhapatnam
In 1974 and in 1975, I underwent otoscerosis operations in my left and right ears respectively. Now hearing in my left ear, which was operated on first, has deteriorated to the extent that it is not sensitive enough, for instance, in a telephone conversation. I am taking B-complex capsules regularly. I am 48 years old, a diabetic for the last 10 years and hypertensive for the last four years. But the problems are under control with a suitable diet, medication and exercise. Now I am afraid that my right ear, which is almost normal, may also develop problems. What am I do about my left ear?
Dr. H. Ganapati replies:
The operation for otosclerosis is done to improve hearing. This does not treat the disease, which can be progressive. In such a case, the disease could have affected your operated ear, gradually resulting in the progressive loss of hearing. Certain types of medication aresupposed to prevent a further deterioration of hearing loss. Also, your diabetes has to be kept under control, which could otherwise result in hearing loss due to nerve damage unrelated to otosclerosis.
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Loss of vision
S. Ragunathan:
My sister-in-law (34), lost her sight after her second child was born. Eye specialists say the problem is due to a nerve problem. Even though she is on medication, she has not regained her vision.
Dr. N.R. Rangaraj, Eye Surgeon, replies:
Numerous physiological or normal changes occur during pregnancy, and the eye is no exception. Even the eye may undergo physiological and pathological (disease) changes. Your question relates to optic nerve changes that include swelling of the optic nerve head (papilledema), acute ischemic optic neuropathy, and optic atrophy (loss of function of the optic nerve). Medications may not be of much value when vision is lost completely due to optic atrophy. Residual low vision may be assisted with low vision aids and low vision training in activities of daily living.
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C. Srinivasan:
I am a computer engineer and unable to tolerate the intensity of any light source, including a visual monitor. An ERG investigation does not reveal any gross retinal degeneration. I have been advised to wear flint glasses which does not seem to help.
Dr. N.R. Rangaraj replies:
Eye-strain, increasing light sensitivity, blurred distance vision after doing close work and excessive blinking are the common problems/complaints of computer users. Studies show that there is no medical damage caused by computers. Monitor screens also do not emit enough harmful rays to cause eye damage.
If your vision and ERG are normal, your symptoms may be due to working long hours before the computer. To relieve the stress and strain, take a break.
It is important to have a correctly lit and structured workstation. The monitor should be about 10 to 15 degrees below eye level and tilted slightly away from you at the top — the way you would hold a book to read. Adjust the screen contrast controls of the monitor to be comfortable and ensure that room lighting is not too bright. The glasses you wear for refractory errors like myopia (short sight), hyperopia (long sight) and presbyopia (age related near vision difficulty) should not be out of date. Special eye protection glasses are not necessary if you normally do not wear glasses when using the computer. Tear substitutes/eye wetting agents may be rarely required to relieve symptoms of dry eye.
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Do write in to
"Ask The Doc", The Hindu Sunday Magazine, 859-860, Anna Salai, Chennai 600002. Or e-mail magazine@thehindu.co.in
Please mention your complete postal address and also whether you'd like your name to be published. Please keep your queries short and focussed. Do not send us your medical reports.
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