Improving Health

Eye and Ear Health

Imaging the Eye

There are many diseases that cause vision loss. NIH funded the development of optical coherence tomography (OCT) technology to diagnose these diseases non-invasively, and there are now over 30 million OCT procedures performed annually in eye clinics worldwide.

Image credit: National Eye Institute, NIH

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  • OCT assessment is fast, painless, and noninvasive, and OCT-based devices are now standard in eye care clinics.
  • OCT is a noninvasive technology that enables imaging of the eye's light-sensing retina to help clinicians identify early signs of disease, monitor disease progression, and evaluate treatment response.
  • The most common vision-threatening diseases in the U.S. affect the retina. These include age-related macular degeneration, diabetic retinopathy, and glaucoma.
  • OCT has also been shown to be effective for monitoring progression of non-vision related diseases such as Alzheimer's and Parkinson’s disease.
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Preventing Blindness

Thanks to NIH, there are now standard treatments for common causes of blindness, including diabetic retinopathy (DR)—a complication affecting a majority of people with diabetes—and both wet and dry age-related macular degeneration (AMD). Drug therapies have become essential for stopping disease progression, reducing blindness caused by wet AMD by 50%.

Image credit: National Eye Institute, NIH

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  • Wet AMD and DR are two leading causes of blindness; both involve abnormal growth of leaky blood vessels in the retina.
  • Early treatments sealed vessels with lasers, which have damaging side effects. Now there are multiple drug options that block vessel formation in wet AMD and DR.
  • NIH clinical trials compared drug safety and effectiveness of these therapies, and NIH supported the development of imaging tools to monitor disease progression and inform dosing.
  • NIH research also led to the development of the first two drugs approved by FDA for late-stage dry AMD in 2023.
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Treatment for Lazy Eye

Roughly 1.5% of U.S. children have amblyopia, known as lazy eye. NIH-supported research informed the guidelines for early treatment of amblyopia, resulting in decreased treatment burden and better outcomes.

Image credit: National Eye Institute, NIH

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  • Amblyopia is a condition where the brain favors visual input from one eye, weakening sensory input from the other. Due to a loss of brain plasticity, treatment becomes increasingly less effective by adolescence, resulting in permanent unilateral vision loss.
  • NIH-funded research has defined the standard for treating amblyopia in children with eyedrops or by temporarily patching the stronger eye. 
  • Studies revealed that a large proportion of children with amblyopia can be successfully treated with less intense treatment regimens than previously thought.
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Gene Therapy for Eye Disease

NIH-funded scientists helped develop the first FDA-approved gene therapy for a degenerative eye disease, Leber Congenital Amaurosis (LCA). This therapy can safely restore normal function and vision in patients, paving the way for other gene-based therapies to treat eye diseases.

Image credit: Wei Li, National Eye Institute, NIH

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  • LCA is caused by defects in a gene essential for normal retinal function.
  • This new gene therapy, Luxturna, was found to be safe, and patients receiving this therapy reported having brighter and clearer vision within weeks of treatment. 
  • Luxturna is the first FDA-approved gene-replacement therapy of any kind to be approved.
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Hearing Loss Screening

As a result of NIH efforts, nearly all infants born in the U.S. today are screened for hearing loss, compared to under 10% screened prior to the universal newborn hearing screening program launched in the 1990s. Early screening allows infants to receive interventions and services during their developmental years when the interventions will be most effective.

Image credit: CanStockPhoto

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  • Approximately two to three in every 1,000 children in the U.S. are born with a detectable level of hearing loss in one or both ears.
  • Around 98% of newborns are now screened for hearing loss in the U.S. through a program developed by Congress as a joint effort by NIH, HRSA, and CDC, with methods and technology developed by NIH-supported researchers.
  • Early identification of hearing loss allows children to receive early interventions and services for healthy language, social, and behavioral development.
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Cochlear Implants

NIH research contributed to the development of cochlear implants, which have become the most common and successful intervention for children who are profoundly deaf or severely hard-of-hearing. Over 80% of children implanted before 18 months of age develop spoken language skills comparable to children with normal hearing.

Image credit: National Institute on Deafness and Other Communication Disorders, NIH

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  • A cochlear implant is a small electronic device that provides a sense of sound to a person who is profoundly deaf or severely hard-of-hearing. 
  • FDA first approved cochlear implants in the mid-1980s to treat hearing loss in adults. Today, cochlear implants are approved for use in children ages 9 months and older.
  • As of December 2019, approximately 736,900 cochlear implants had been implanted worldwide. In the U.S., roughly 118,100 devices have been implanted in adults and 65,000 in children.
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Hearing Aid Access

In 2022, FDA allowed for the first time over the counter (OTC) sales of hearing aids, enabling adults with mild to moderate hearing loss to buy them directly. This ruling increases access and decreases costs of hearing aids and FDA made this ruling based on decades of NIH-funded research.

Image credit: Department of Speech and Hearing Sciences, University of Washington

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  • One-third of people over the age of 65, and half of those 75 years and older, have hearing loss.
  • Prior to this FDA decision, only one in five people who could benefit from hearing aids used them.
  • NIH-supported research has shown that hearing loss is associated with an increased risk of dementia, falls, depression, social isolation, anxiety, and reduced mobility.
  • Treatment of hearing loss, in part through hearing aids, can improve communication, sociability, and overall quality of life.
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References

Imaging the Eye

  1. Fujimoto J, et al. Invest Ophthalmol Vis Sci. 2016;57(9):OCTi-OCTii. PMID: 27419359.
  2. Special Issue: 25 years of optical coherence tomography. Invest Ophthalmol Vis Sci. 2016. https://iovs.arvojournals.org/ss/octissue.aspx
  3. Doustar J, et al. Front Neurol. 2017;8:701. PMID: 29312125.

Preventing Blindness

  1. Article: NIH study finds Avastin and Lucentis are equally effective in treating age-related macular degeneration: https://www.nei.nih.gov/about/news-and-events/news/nih-study-finds-avastin-and-lucentis-are-equally-effective-treating-age-related-macular-degeneration
  2. Bloch SB, et al. Am J Ophthalmol. 2012;153(2):209-213.e2. PMID: 22264944.
  3. Article: Comparison of AMD Treatments Trials (CATT): Lucentis — Avastin Trial: https://www.nih.gov/news-events/news-releases/comparison-amd-treatments-trials-catt-lucentis-avastin-trial
  4. CATT Research Group. N Engl J Med. 2011;364(20):1897-908. PMID: 21526923.
  5. Diabetic Retinopathy Clinical Research Network. N Engl J Med. 2015;372(13):1193-203. PMID: 25692915.
  6. Eye Health Data and Statistics: https://www.nei.nih.gov/learn-about-eye-health/eye-health-data-and-statistics
  7. Solomon SD, et al. Cochrane Database Syst Rev. 2019;3(3):CD005139. PMID: 30834517.
  8. Common Eye Disorders and Diseases: https://www.cdc.gov/visionhealth/basics/ced/(link is external)(link is external)
  9. Am I at risk for diabetic retinopathy?: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/diabetic-retinopathy#:~:text=Anyone%20with%20any%20kind%20of,diabetes%20will%20develop%20diabetic%20retinopathy
  10. Article: Story of discovery: NEI-funded research paves way for new dry AMD drugs: https://www.nei.nih.gov/about/news-and-events/news/story-discovery-nei-funded-research-paves-way-new-dry-amd-drugs

Treatment for Lazy Eye

  1. Pineles SL, et al. Ophthalmic Epidemiol. 2022;29(5):537-544. PMID: 34459319.
  2. Statement on the Success of Reduced Daily Eye Patching to Treat Severe Amblyopia: https://www.nei.nih.gov/about/news-and-events/news/statement-success-reduced-daily-eye-patching-treat-severe-amblyopia

Gene Therapy for Eye Disease

  1. Article: NIH vision researcher T. Michael Redmond recognized with Champalimaud Vision Award: https://www.nei.nih.gov/about/news-and-events/news/nih-vision-researcher-t-michael-redmond-recognized-champalimaud-vision-award

Hearing Loss Screening

  1. Article: New law to strengthen early hearing screening program for infants and children: https://www.nidcd.nih.gov/news/2017/new-law-early-hearing-screening-infants-and-children
  2. Hearing Program: https://www.nidcd.nih.gov/research/extramural/hearing-program
  3. National Institute on Deafness and Other Communication Disorders: https://www.nih.gov/about-nih/what-we-do/nih-almanac/national-institute-deafness-other-communication-disorders-nidcd
  4. Early identification of hearing impairment in infants and young children. NIH Consensus Statement. 1993;11(1):1-24. PMID: 8401641.
  5. Olusanya BO. Int J Pediatr Otorhinolaryngol. 2011;75(3):316-21. PMID: 21211856.
  6. van Dyk M, et al. Int J Pediatr Otorhinolaryngol. 2015;79(7):1034-40. PMID: 25921078.
  7. Data and Statistics About Hearing Loss in Children: https://www.cdc.gov/ncbddd/hearingloss/data.html
  8. Joint Committee on Infant Hearing 1994 Position Statement: http://www.jcih.org/JCIH1994.pdf
  9. World Health Organization: Global costs of unaddressed hearing loss and cost-effectiveness of interventions. 2017. https://apps.who.int/iris/bitstream/handle/10665/254659/9789241512046-eng.pdf
  10. Grosse SD. Volta Voices. 2007;14(6):38-40.
  11. Quick Statistics About Hearing: https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing

Cochlear Implants

  1. Cochlear Implants: http://www.nidcd.nih.gov/health/hearing/pages/coch.aspx
  2. Semenov YR, et al. Ear Hear. 2013;34(4):402-12. PMID: 23558665.
  3. Crowson MG, et al. Audiol Neurootol. 2017;22(4-5):236-258. PMID: 29262414.
  4. Bond M, et al. Health Technol Assess. 2009;13(44):1-330. PMID: 19799825.
  5. Semenov YR, et al. Otolaryngol Clin North Am. 2012;45(5):959-81. PMID: 22980678.
  6. Quick Statistics About Hearing: https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing
  7. Nucleus 24 Cochlear Implant System: https://www.fda.gov/medical-devices/recently-approved-devices/nucleus-24-cochlear-implant-system-p970051s205

Hearing Aid Access

  1. Medical Devices; Ear, Nose, and Throat Devices; Establishing Over-the-Counter Hearing Aids: https://www.federalregister.gov/documents/2022/08/17/2022-17230/medical-devices-ear-nose-and-throat-devices-establishing-over-the-counter-hearing-aids
  2. Milestones to OTC Hearing Aid Final Rule: https://www.nidcd.nih.gov/news/multimedia/milestones-to-otc-hearing-aid-final-rule
  3. Over-the-Counter Hearing Aids: https://www.nidcd.nih.gov/health/over-counter-hearing-aids
  4. Quick Statistics About Hearing, Balance, & Dizziness: https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing
  5. Age-Related Hearing Loss (Presbycusis): https://www.nidcd.nih.gov/health/age-related-hearing-loss
  6. Article: FDA’s new category of hearing aids advances hearing health care: https://www.nidcd.nih.gov/about/nidcd-director-message/fdas-new-category-hearing-aids-advances-hearing-health-care
  7. Article: Hearing aids slow cognitive decline in people at high risk: https://www.nia.nih.gov/news/hearing-aids-slow-cognitive-decline-people-high-risk   

This page last reviewed on January 17, 2025