FDA Clears Path For Hearing Aids To Be Sold Over the Counter (nytimes.com) 143
An anonymous reader quotes a report from the New York Times: The Food and Drug Administration decided on Tuesday to allow hearing aids to be sold over the counter and without a prescription to adults, a long-sought wish of consumers frustrated by expensive exams and devices. The high cost of hearing aids, which are not covered by basic Medicare, has discouraged millions of Americans who have hearing loss from buying the devices. Health experts say that untreated hearing loss can contribute to cognitive decline and depression in older people. Under the new rule, people with mild to moderate hearing loss should be able to buy hearing aids online and in retail stores as soon as October, without being required to see a doctor for an exam to get a prescription.
The F.D.A. cited studies estimating that about 30 million Americans experience hearing loss, but only about one-fifth of them get help. The changes could upend the market, which is dominated by a relatively small number of manufacturers, and make it a broader field with less costly, and perhaps, more innovative designs. Current costs for hearing aids, which tend to include visits with an audiologist, range from about $1,400at Costco to roughly $4,700elsewhere. The F.D.A.'s final rule takes effect in 60 days. Industry representatives say device makers are largely ready to launch new products, though some may need time to update labeling and packaging or to comply with technical details in the rule. "This could fundamentally change technology," said Nicholas Reed, an audiologist at the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health. "We don't know what these companies might come up with. We may literally see new ways hearing aids work, how they look."
The F.D.A. cited studies estimating that about 30 million Americans experience hearing loss, but only about one-fifth of them get help. The changes could upend the market, which is dominated by a relatively small number of manufacturers, and make it a broader field with less costly, and perhaps, more innovative designs. Current costs for hearing aids, which tend to include visits with an audiologist, range from about $1,400at Costco to roughly $4,700elsewhere. The F.D.A.'s final rule takes effect in 60 days. Industry representatives say device makers are largely ready to launch new products, though some may need time to update labeling and packaging or to comply with technical details in the rule. "This could fundamentally change technology," said Nicholas Reed, an audiologist at the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health. "We don't know what these companies might come up with. We may literally see new ways hearing aids work, how they look."
Sweet (Score:3)
Something is better than nothing (Score:2)
This is great, up to a point. People might start doing like they do with reading glasses, and keep postponing an actual visit to an audiologist until too late.
According to the summary, presently 80% of people never seek professional help. So for them, a consumer-grade solution is better than no solution, which is the current state of things.
Re: Something is better than nothing (Score:2)
Re: Something is better than nothing (Score:5, Insightful)
Agree, but I bet that the reason people don't go to an audiologist is the high costs. Not everyone has insurance and even those that do might not be able to afford the co-pay/deductible.
The thing is, if you're just talking about getting a hearing aid, AFAIK, most of what an audiologist does for those folks could largely be replaced by software. Build a hearing aid with Bluetooth input and provide instructions: click or tap "I hear it" when you hear a tone. Repeat for a different frequency until done. Compute a response curve. Compute a filter bank that roughly compensates for that curve. Store the profile.
Even better, because it doesn't require an expensive appointment and a huge chunk of time, the software could force you to recalibrate once a month for the first six months, and then once a year after that, using the previous curve as a baseline for compensation, thus making the profile progressively more accurate over time.
Mind you, tech can't catch everything. It will miss things like ear wax buildup, infections, etc. So if hearing loss is sudden, buying a hearing aid is likely to be a mistake. But for the most part, this seems like it has the potential to massively improve a lot of people's lives, and I'm surprised this didn't happen a decade ago.
And of course, because they'll be sold over the counter, the potential exists for economies of scale bringing the price down considerably.
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This is very well explained - almost like you've gone through it personally. This is, in fact, very similar to the "mapping" that we do with a cochlear implant: the response for each band is custom tuned, and, at least at first, is revisited over a period of months to tweak performance.
Although dgatwood's proposed procedure is quite reasonable, it is not revelatory, sorry!
Other than the re-calibration and historical-averaging, it is essentially the same as many non-tech-averse audiophiles use with audio-analysis software such as the most-excellent REW to create response (and equalization) curves for home audio and home theatre systems. In fact, some even create response and equalization curves for headphones and earbuds/IEMs using specialized acoustic couplers.
Doesn't invalidate the proc
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Speakng of which, if I ever need hearing aids, I want to be able to EQ them to a "Harman Curve" response!
https://headphonesaddict.com/h... [headphonesaddict.com]
I've never understood why equalization curves are necessary for making music sound good. Isn't that what the audio engineer should have done during mixing or mastering? Why don't we use equalizers to just correct for weird speakers or weird media? (Alternatively, if it sounds best for the mid-high bands to be louder, why haven't musicians learned to play louder in those bands?)
It just doesn't make sense that a certain frequency boost sounds good but it hasn't been incorporated into music.
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Audio engineers use speakers with flat EQ in a dampened room. Headphones play back the same sound but with a flat representation and no echo/absorption. The curve attempts to replicate the effect of speakers in a room and approximate the experience of being in the audio engineer's studio.
I never listen to music in silence so it wouldn't do much for me, but it isn't completely crazy either.
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This is very well explained - almost like you've gone through it personally.
I went through a routine hearing test as a kid. But no, that's mostly because I did some research into hearing aids for my folks recently, and concluded that the market is utterly insane. You could write some DSP code that runs on commodity hardware that costs $25, and it would produce comparable results, but between the patent minefield and the regulatory minefield (FDA approval requirements — why!?!), a small number of companies have oligopolized the market and charge upwards of $1,000 for these t
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Great post. I came to post something similar but your explanation was worded better.
With all the noise-cancelling headphones, noise-cancelling microphones, auto-tune singing aids, and plenty of prior art to emulate, I would be surprised if user-friendly versions aren't in the stores in less than a year. Inexpensive behind-the-ear models shouldn't cost more than a good pair of noise-cancelling headphones. Can't wait to see the Bose and Beats brand hearing aids.
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My dad had to go through an audiologist and he ended up paying thousands of dollars for something that, at most, was worth a couple hundred
The reason that he was hard of hearing, was because he was old, there was no other diagnosis, as for most people
Also, the captured market for hearing aids totally prevents resale, so it is just another bucket of money flushed down the toilet as you enter your golden years
Re: Sweet (Score:2)
Too late for what?
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This is great, up to a point. People might start doing like they do with reading glasses, and keep postponing an actual visit to an audiologist until too late.
Too late for what though? I have pretty severe tinnitus. Overall heating loss with severe high frequency loss - I don't hear anything above 3 KHz, and it's been that way since I was 18, almost 50 years now. My weird noggin processes all sounds equally. That's why people with tinnitus can't hear in noisy environments, they cant differentiate between intelligence and background noise. . The only "cure" for my issue is severing the auditory nerve, hardly a cure at all. But some people are driven half crazy by
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what exactly is too late here? I'm not aware of hearing being involved with many degenerative type diseases
Didn't TFS mentioned a possible link between uncorrected hearing loss and cognitive decline?
Sounds pretty degenerative to me.
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what exactly is too late here? I'm not aware of hearing being involved with many degenerative type diseases
Didn't TFS mentioned a possible link between uncorrected hearing loss and cognitive decline?
Sounds pretty degenerative to me.
Age might be associated with that as well. Every person I've known with "normal" cognitive loss has been old.
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what exactly is too late here? I'm not aware of hearing being involved with many degenerative type diseases
There is a very slight possibility that a noggin tumor might be causing the problem. But unless a person has been hearing fine for decades, and suddenly has deafening tinnitus and total hearing loss, it's the normal causes.
So they were not just sold before...??? (Score:2)
Are there any other mundane things only available "by prescription" in the US that we should know of...?
Re: So they were not just sold before...??? (Score:3)
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They are classified as a medical device so that adds an extra zero or two onto the price. Most people should have a decent hearing test to determine the frequency dropoff and tune the devices appropriately.
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I remember when the first tablet computers came out. The medical hardware business had a screeching fit when people stopped buying their clunky, single application text-to-speech boxes and downloaded a cheap app.
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The rule of thumb is: anything the government (of any country) touches turns to crap.
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I have two.
First, Eyeglasses. Excluding simple magnifying glasses, require a prescription and that prescription expires after a period of time.
Second, medical grade oxygen requires a prescription. This was an obstacle, though not an insurmountable one, when I built my DIY diving rebreather. I was able to get aviation oxygen instead. Still breathable, different certification.
A wheelchair or power chair
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The US has its issues, to be sure. Expensive medical treatment is one of them. But some things are actually cheaper her. For example, cars, land, gasoline, clothing, technology, and many groceries are cheaper in the US.
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Even if those things are cheaper in the US the increased cost of healthcare outpaces all of them. Most of those items if they are more expensive is in an increase of a few to 10%. Even car costs are pretty even once you calculate the full, taxes out the door prices rather than sticker costs. The per/capita costs of healthcare is around $11k US compared to around $6k in most EU countries (Germany, France, UK), $5k a year adds up not to mention all the stress and negative externalities our system brings w
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The current US economy is set like vultures to consume each generation's wealth as they enter old age.
This prevents the accumulation of multi-generational wealth and keeps the proles where they belong (slaving away for their bettors of course)
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You pay more and get less than everyone else and yet you still think that "we have some of the best care in the world" as if you're ever going to see the inside of one of those rich people hospitals.
Re: So they were not just sold before...??? (Score:4, Insightful)
I'm glad to hear that you can get good healthcare, but the hospital my wife worked at in rural Georgia would have been shut down if it was in the UK where she had worked previously. (Her words)
Also, This link has a brief insight into how bad things are. [spendmenot.com]
Here's an overview:
Americans spend an average of $5,000 a year on out-of-pocket healthcare costs.
Almost 60% of US adults have had medical debt at some point in their life.
70% of Americans with medical bills had to cut their food expenses to avoid bankruptcy.
Two-thirds of all personal bankruptcies are due to medical bills.
20% of medical bankruptcy filers are in the 55+ age group.
Almost half of those who filed for medical bankruptcy cite hospital bills as their most considerable expense.
39% of Americans are more worried about medical bills than Covid-19.
Those things are completely foreign to the rest of the world. You could do so much better.
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So, your wife was comparing a poorly-run hospital in the US, against a well-run hospital in the UK. Knowing human nature, I can guarantee that the UK also has some poorly-run hospitals, as does the US. It is certainly true that rural hospitals in the US do not provide the same quality of care as the cities. I suspect that rural hospitals everywhere struggle to perform, due to the relative lack of resources inherent in small town life.
I did say at the outset that US healthcare is expensive, I have no argumen
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The big money in U.S. health care causes many problems, because people want that money. And it's a service business, which means dealing with annoying patients.
It's anecdotal, but everybody has heard medical mistake stories because that's what people notice and talk about. I've heard surprisingly bad stories from well-regarded hospitals. Then there are the lower level hospitals. Consolidation means most hospitals are run with the incentives and mechanics of a large company. The labor force is expensive (no
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I suppose if your local health system is poor, you could hope another corporation buys it. Or something.
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Oh yes, because human nature, and politics, are so different in the UK and everywhere else but the US. Got it.
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No, if she said it would be shut down in the UK, that means it's worse than the worst hospitals in the UK. You may think she's wrong, but don't misconstrue the claim.
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I think the point is that the expensive but bad US hospital being worse than an inexpensive but better UK hospital means that the higher cost does not drive quality care.
Re: So they were not just sold before...??? (Score:2)
That is definitely part of the problem and should be fixed but it's far from the only problem. We should also accept foreign doctors qualifications instead of making them resident all over again.
And the meme about America being the best of the best is not so true anymore and by the total health outcomes we are middling.
Wealthy foreigners can come here for surgery but normal Americans have to fly to other countries to afford it. That system is not right.
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I actually live in America, and I can assure you that there is no artificial limit on how many doctors and surgeons can practice. If you get the education necessary to become a doctor, no one stops you from going into practice. It's completely wide open.
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Medical education for M.D.'s and their specialties is in fact highly allocated, unless something has changed in the last decade. One change has been more D.O.'s. Osteopathy schools are opening a lost faster than M.D. schools. In my area some D.O. operation out of an adjoining state has opened more than one program in schools that previously only had nursing degrees. Something like 40% (?) of all physicians in the U.S. military are D.O., including Trump's Covid-19 doctor. A university M.D. I talked to didn't
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*a lot, not a lost!
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I'd like to see a source for your assertions. I have worked in the healthcare industry in the US for many years, both on the physician side and on the insurance side, and have never encountered any such limits.
As for Physician Assistants and Nurse Practitioners, the rise of these people acting as "doctors" has been purely financial. They cost less, so people have turned to them as a way to save money. It has nothing to do with artificial limits.
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In my experience that isn't the largest driver. IMHO, insurance company discounting is the big problem. Here's how it works.
DocZ needs $50 for an office visit to pay their salary, the Nurse, Receptionist, and Light bill. Insurance company InsCo requires a 66% discount for DocZ to be in their network. To be able to stay in business DocZ raises their price from $50 to $150. They still make the $50, the insurance company gets their disco
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Doctors need $50 for a 3 minute office visit and they are booked back to back the entire day. I'm going to guess lights aren't that expensive and that it's medical school debt and malpractice insurance. Both things that don't have to be as expensive as they are and they aren't elsewhere.
Insurance companies typically don't negotiate "discounts." They set an allowed amount per visit. If they say $50 it doesn't matter what your cash price is as long as it's not less than $50. In practice, it would be more
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Insurance companies very much do negotiate discounts, and you can see it for yourself. Log in to your health insurance and look at some of your EOB forms.
For MD/PA visits it's usually around 50%. For lab testing the discounting is often > 80%. I'd be happy to share some of the egregious examples if you'd like to see some of mine. I had a lab drug test* that billed initially at over a thousand dollars and after discounting was under $20.
* - required in my state for ADHD medication prescriptions for...
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I can't see for myself, because that's not how my insurance company does it. But I'll take your word for it.
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The US has its issues, to be sure. Expensive medical treatment is one of them. But some things are actually cheaper her.
I can't afford insulin, glasses, or a hearing aid, but by golly I got a t-shirt and a banana for $3 at WalMart. USA! MAGA!
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I think we're in agreement. The price of healthcare in the US is too high. This step towards making hearing aids cheaper and available over the counter, is a step in the right direction. There are many more steps to go.
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What are you talking about? It's not a permission slip like prescriptions for drugs, it just tells you what to buy.
I bought my last pair of prescription eyeglasses online for $9. I have another pair I bought for $6. I entered the numbers so that I could get the correct lens, but that's all. They didn't ask for any information about the doctor.
requiring a doctor just inflates the price of something we could do for ourselves.
That seems kinda stupid, but you absolutely can do that yourself today. My last eye exam, which I got just a few years ago, cost me about $60. That's not exactl
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Your online glasses purchase without a prescription...was illegal. Mind you, I don't care, all I'm saying is that to purchase corrective lenses legally, you do actually need a prescription.
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Cite the law, then. Because it's not illegal. If it was, the multitude of companies doing it for the last decade would already be bankrupted.
Now, buying CONTACTS - yes, those require a prescription. But glasses do not.
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https://www.allaboutvision.com... [allaboutvision.com].
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This isn't some shifty back alley deal here. There are quite a few companies that have been operating out in the open for years without issue. Zenni [zennioptical.com] (founded in 2003) is no small operation. Neither is Warby Parker (2010). I can easily go on.
Are you going to tell me how that these companies can so brazenly flaunt the law for decades without consequence?
Oh, as I have already explained to you, I have a prescription. I needed one so that I would know what to order. I recommend anyone buying eyeglasses con
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Rules vary from state to state, but yes, most states do require you to get a prescription from a licensed optometrist in order to buy glasses. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://s3-us-west-2.amazonaws.com/production-public-wp-content/wp-content/uploads/2016/10/Prescription-Eyeglass-Regulations-2016-update.pdf
Web sites breaking the rules? Say it ain't so! This is the entire business model of Uber and Lyft. In many, many cities they began to offer rides to people despite local laws fo
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Two things: 1) Learn how URLs work. 2) You can do better than a blog.
Zenni in particular has been operating without issue for 20 years. You're very clearly mistaken. There's a reason, I suspect, that you're posting links to blogs instead of actual legislation.
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Here's the correct link: https://s3-us-west-2.amazonaws... [amazonaws.com] (not a blog, by the way)
The reason it's hard to find the original statutes and regulations is that Google searches focus on patient rights to a copy of the prescription, rather than the requirement of needing a prescription. All of the results simply assume that a prescription is part of the process.
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Not a blog? It's wordpress, for goodness sake.
The reason it's hard to find the original statutes and regulations is that Google
I guess I can't expect you to provide good information if you don't know how to find it. IANAL, but I didn't think you'd need to be to find this stuff. I'm pretty secure in my position, so I don't mind helping you out:
Behold! The U.S. Code: https://uscode.house.gov/ [house.gov]
Individual states will have their own thing. Pick a state and I can help you find it. Here's California [ca.gov]. The CA board of optometry publishes this guide [ca.gov]. I picked CA because it's a large state.
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Sure, it's easy to find generic links to the US Code and state laws. But eyeglasses regulations aren't in the code, they are in regulations issued by the FDA.
Since you're so good at Googling, why don't you produce a link to a specific regulation refuting what I'm asserting, that a prescription is required to legally purchase corrective eyeglasses? I've provided two indirect links backing me up. Where's your source?
It seems you are more interested in putting me down, than finding the facts.
Good luck.
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Your online glasses purchase without a prescription...was illegal. Mind you, I don't care, all I'm saying is that to purchase corrective lenses legally, you do actually need a prescription.
His last eye exam netted him a prescription. He is free to have that prescription "filled" by anyone he chooses.
Unless he has a complex prescription, sending a scan/picture of an optical prescription to an online service should be (and is) as legal as walking into a local optimetrist and handing it to them.
Afterall, you aren't talking about something like medicine, that you put in your body. When you put on a pair of glasses, you'll know pretty damned quick if they aren't right!
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I think you are agreeing with me. You noted that he had a prescription, thus fulfilling the legal requirement. Yes, you can use that prescription anywhere. I agree, you aren't putting something in your body, and eyeglasses should be more freely available, even without a prescription.
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Eye exams are the only way to catch glaucoma before blindness, and famously some non-optical health conditions can be detected looking into the eye. And like you say, the exams are not expensive.
Audiology on the other hand has been very expensive for a long time. The manufacturers run a bit of a cartel, as well the clinics having a proven business model. Whatever happened to the idea an iPhone app could do as good a job as hearing aids? Squashed as a medical device? Didn't work as well as expected? That was
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Eye exams are the only way to catch glaucoma before blindness, and famously some non-optical health conditions can be detected looking into the eye. And like you say, the exams are not expensive.
Audiology on the other hand has been very expensive for a long time. The manufacturers run a bit of a cartel, as well the clinics having a proven business model. Whatever happened to the idea an iPhone app could do as good a job as hearing aids? Squashed as a medical device? Didn't work as well as expected? That was like ten years ago.
I typed "hearing aid" into the App Store search, and got a list that had too many to scroll through. Some are control panels for hearing aid products; but a lot seem to be geared toward using a set of earbuds as a hearing aid. Most have multi-band EQs, and some claim to offer up to a 100 X (!!!) amplification-factor.
So, it appears to be covered. I would imagine the Google Play Store has similar offerings, too.
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Re:So they were not just sold before...??? (Score:5, Interesting)
Even if you GO to an eye doctor, half the time they'll deliberately undercorrect astigmatism just because you've been "habitually" undercorrected.
Seriously, if you want your next pair of glasses to be a REAL improvement (and you have astigmatism), there are two things you need to do:
1. Pay attention to the numbers the autorefractor spits out... particularly, the cylinder strength. When the doctor examines you, he's almost certainly going to hand you a prescription with weaker cylinder strength. Why? Because "normal" (cheap) glasses with lots of cylinder power have *horrific* amounts of barrel/pincushion distortion... especially around the periphery. So... you need to reassure him that you're going to do the next step, too.
2. If you have astigmatism, you absolutely, positively want lenses that are "atoric" (sometimes called "double-aspheric"). As a practical matter, this usually means you want "freeform" lenses.
For decades, optometrists have been gaslighting patients by simultaneously pretending uncorrected astigmatism isn't a "big deal", and systematically undercorrecting it to avoid dealing with patients complaining about the distortion caused by poor lens designs combined with high cylinder power. Contrary to what some doctors will claim, an autorefractor is likely to be more honest about the amount of power it'll take to fully-correct your astigmatism than the doctor himself will EVER be.
The thing is, doctors aren't entirely wrong about distortion being a serious problem with high amounts of cylinder power. The fix, though, isn't to under-correct your astigmatism to make up for shitty lens optics that cause unacceptable distortion, the fix is to get better lenses with less distortion (even at higher cylinder powers).
Twenty years ago, Hoya sold outrageously expensive pre-freeform atoric lenses that opticians absolutely HATED because they took WEEKS to order, required extra training (or at least, a few hours of reading) to order correctly, and because they were so outrageously expensive, they usually ended up going through 2 or 3 rounds of remakes, because someone spending more than a thousand dollars on lenses expects flawless perfection... and few opticians handled enough orders for them over the course of a year to actually GET enough experience to do it right on the first try.
"Freeform" isn't a lens type or design, it's a manufacturing process that enables any random lens lab with the right gear to grind arbitrary curves (including atoric ones) onto lens blanks. This is part of what made atoric lenses finally halfway-affordable in the US. In the past, Hoya basically had one manufacturing facility in the entire US handling its atoric lenses. When it got an order for a new sphere+cylinder combo, it put it in the queue, made a few dozen lenses with that combo, shipped one to the optician, and put the rest in the warehouse to use for future orders. Zeiss actually did something similar in Europe in the early 1900s with its "Punktal" lenses.
Ever notice how circa WWII, all the senior German & Japanese leaders wore round glasses? It wasn't because eyeglasses didn't exist in other shapes... it was because expensive *Punktal* lenses (worn by wealthy and powerful German & Japanese leaders) were possible with early-1900s technology because they made certain assumptions about their wearing position... and to take advantage of their design, there was exactly one correct position that the frames HAD to match, period. Kind of like today's position-of-wear optimized lenses, but in reverse... Zeiss employed an army of mathematicians to do the raytracing by hand for exactly one scenario per sphere+cylinder-power (in 0.125-diopter increments), and made everyone adapt themselves to it. The bonus was... ENORMOUSLY better performance (in terms of clarity and minimizing off-center/off-axis distortion).
It was, ironically, American eyeglasses that dragged the whole industry down into the optical nadir of the 1970s and 1980s... when lenses became larger, but their per
Re:So they were not just sold before...??? (Score:5, Insightful)
A few more thoughts:
If the autorefractor suggests a prescription with WAY more cylinder power than the doctor is willing to prescribe, don't buy new glasses that day. Take the doctor's prescription, and also note the numbers from the autorefractor.
Go to Zenni, and buy two pairs of their cheap glasses... the $6.95 ones. Buy the same frames in two different colors so you can tell them apart.
For pair #1, order them with the prescription your doctor gave you.
For pair #2, order them with the prescription the autorefractor spit out.
For both pairs, use the same axis numbers. If they're different on the autorefractor and official prescription, you'll probably be happier with the axes from the official prescription. The thing is, every pair of glasses you wear really needs to have the same axis values (left and right axis can and will differ, but you'll want all of your glasses to have the same value for left axis, and all of your glasses to have the same value for right axis). If you wear (or plan to get) disposable soft lenses, make sure your doctor knows... this is one specific case where compromising from your ideal glasses-axis is desirable. If your disposable contacts are only available with a few axis values, match your glasses to them.
Get them with standard 1.50 index lenses. Medium-index lenses are a little thinner... but optically, medium-index lenses SUCK.
Skip the coatings. If you're buying "real" glasses from Zenni, their oleophobic antireflective coating is generally worth it and good... but these aren't your "real" glasses, they're just a proof-of-concept demonstration to let you see the difference between the two prescriptions and decide for yourself which one you like better.
Be aware that if you have lots of cylinder power, they'll probably have a lot more distortion than you'd consider acceptable. For now, you're just going to have to take my word for it that atoric freeform lenses will have a LOT less distortion, and a much larger "sweet spot". The goal of this experiment is to let you see how much clarity you've been missing by undercorrecting your astigmatism.
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If you need "reading" glasses, you can take the Zenni experiment a step further. Once you've determined your optimal base prescription for distance, go back and order 3 or 4 pairs of cheap glasses (once again, with different-color frames) over a range of magnification powers (say, +0.50, +1.00, +1.50, and +2.00). Remember, that number is simply added to the "sphere" strength of each eye, with no other changes to cylinder or axis. This allows you to cheaply experiment with a range of different powers the same way someone without astigmatism could, just by going to a discount store and buying "reading glasses" off the rack. You might want to go back for a second round of refinement to try powers like +0.75, +1.25, +1.75, +2.25, etc to get a feel for the situations where each power is optimal. Even if you end up buying one or more pairs of "good" (expensive) reading glasses, your Zenni collection will probably come in handy late at night when your eyes are completely shot, or if your "good" glasses ever get broken.
For the record, the glasses you ordered in phase 1 (to pick your preferred cylinder power) also come in handy if you're going to find yourself in a situation where you need glasses, but really shouldn't be risking damage to a $500+ pair of glasses. Or, say, if your good glasses get lost or broken. People without astigmatism just don't understand how awful it is to lose your glasses if you have literally only one pair. Nearsightedness or farsightedness without astigmatism sucks, but astigmatism -- alone or in combination -- sucks WAY more, and leaves you in a much worse position if you find yourself without glasses for days waiting for replacements.
I should also mention that Zenni's "Workspace" (intermediate distance) progressive lenses are surprisingly good. No, they aren't as good as entry-level freeform lenses, but for the price, you really can't beat them..
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Re: So they were not just sold before...??? (Score:3)
Yeah, I had problems finding a doctor, too. I went down the list of SE Florida doctors on Shaw's site & either the person I talked to on the phone had no idea what I was talking about (re Shaw), or wouldn't do the testing "because it required too much interaction, and... er... Covid (the all-purpose excuse)". I finally ended up going a hundred miles to Naples.
Shaw lenses are expensive, but in their defense, they really aren't much more expensive than any OTHER high-end Trivex freeform lenses with antire
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Outstanding comment. Thank you.
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Outstanding information! Thank you for sharing all of this. Saving for future reference.
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There are eye issues that can creep up on you and slowly turn into massive issues. My eye doc actually checks for glaucoma, cataracts and other stuff that getting old brings on. She doesn't push glasses which I don't need yet (but I'm close).
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There are eye issues that can creep up on you and slowly turn into massive issues
This concern is true for many areas of medicine. Cancer is one example. There are over 5 million new skin cancer cases every year in the US. https://www.cancer.org/cancer/... [cancer.org]). But we don't make people get a skin cancer screening before they can buy sunscreen.
By contrast, there are a grand total of 3 million glaucoma cases in the US. https://www.brightfocus.org/gl... [brightfocus.org] But in order to induce people to get screened, we require a glaucoma screening yearly to get new glasses?
Yes, people should be screened. But
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>Another mundane thing that requires prescriptions are prescription eyeglasses.
They really don't. Go to any online eyeglass place (and probably most opticians) and put in whatever numbers you want, and they'll happily sell you prescription eyeglasses with that correction.
Getting tested so that you can order glasses with the *right* correction is a very good idea - but it's not legally required.
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Contact lenses on the other hand...
It's about time! (Score:5, Insightful)
The audiologist racket has gone one long enough. For 90% of people who are hard of hearing, there is no reason a doctor should be required. And there is certainly no reason a pair of earbuds that happen to be called "hearing aids" should cost thousands of dollars!
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I've got to disagree. Hearing aids don't just make everything louder, they have a frequency response so that they only make louder the frequencies that you have trouble hearing, to avoid damaging your hearing at the frequencies you can still hear okay.
Still, that's like getting an eyeglass prescription - should be a relatively cheap test the doctor gives you, and then any idiot can configure your hearing aid to match.
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I've got to disagree. Hearing aids don't just make everything louder, they have a frequency response so that they only make louder the frequencies that you have trouble hearing, to avoid damaging your hearing at the frequencies you can still hear okay.
Still, that's like getting an eyeglass prescription - should be a relatively cheap test the doctor gives you, and then any idiot can configure your hearing aid to match.
In one way, it's not at all like an eyeglasses prescription. You need significant hardware to test someone's eyes, including an eye chart at a predefined distance and a set of lenses. Almost nobody can realistically do that test at home.
But hearing? All you need is a set of earbuds with a well-defined response curve, and the hearing aid itself already provides you with that. From there, the test can be automated in software. Tap the left, right, or both button when you hear a beep. All a human does is
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The eye chart and other things are trivially easy to do at home - you just need them at a certain size and you can easily calibrate printers and screens to do it.
The expensive part is the equipment - the little rack of lenses and such that they can adjust to figure out your
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Likewise, an audiologist can examine you for hearing, but the exam should also include an inspection of your ear canal and eardrum to make sure there's nothing of concern, and the exam should be cheap and you end up with a hearing aid prescription, if necessary.
Sure, but realistically, most people know when they need a hearing aid. And your ear canal gets examined by doctors every time you get a checkup, unlike your eyes. :-) I mean yes, ostensibly your hearing loss could be caused by inflammation or wax buildup, but your GP can tell you that. You don't need an audiologist. Save the specialists for conditions where specialists are actually needed.
Eyeglasses are expensive purely because of Elissor-Luxxotica monopoly - turning a $2 frame into a $500 frame (it's a piece of injection molded plastic or a piece of metal - it doesn't cost much money).
No, eyeglasses are expensive largely because they're a profit center for your eye doctor, who charges as much as yo
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There's also neural problems that can cause hearing loss though, and the last thing you want to do is cause deafness by blasting loud sounds into your ear when the ear is fine, and it's the nerves that have a problem. Then you end up neglecting the real problem until it gets much worse, and now it's barely worth fixing anymore because you've already damaged your ears so badly that they're no longer sending signals anyway.
A big chunk of of the normal testing for either corrective is ruling out other possibl
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There's also neural problems that can cause hearing loss though, and the last thing you want to do is cause deafness by blasting loud sounds into your ear when the ear is fine, and it's the nerves that have a problem. Then you end up neglecting the real problem until it gets much worse, and now it's barely worth fixing anymore because you've already damaged your ears so badly that they're no longer sending signals anyway.
The auditory nerve is entirely inside the skull, so there aren't a lot of opportunities for nerve impingement. So except in the rare cases where there's some obvious physical cause, like a tumor pressing against the auditory nerve, auditory neuropathy is generally not treatable (other than with a hearing aid), AFAIK.
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Printed eye charts won't tell you anything about astigmatism though - something many/most people have, and which needs additional correction. As I recall it basically comes down to your eye (and lens) being vaguely football-shaped rather than perfectly round, which... I *think* means you essentially need a different correction vertically and horizontally. You can compromise with a basic lens, but you'll never get to 20/20, instead over-correcting on one axis and under-correcting on the other. And I belie
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An eye doctor wows you with lots of expensive equipment, but most of it isn't truly necessary. What is the actual point of glasses? To enable you to see and read. You can tell when glasses work for you by putting them on and trying to read, just like you can already do at the rack of reading glasses at the big box store. When the glasses are right, you'll know it.
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Hearing loss follows predictable patterns. It's not like your hearing loss is so unique compared to other people's hearing loss, that you must have a custom solution tailored just for you. Yes, just like eyesight, there are varying degrees. But making safe and effective hearing aids can be done through regulation of the manufacturers. For most, individual customization isn't necessary.
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> Hearing aids don't just make everything louder, they have a frequency response so that they only make louder the frequencies that you have trouble hearing
The over-the-counter ones should have a frequency slider or two so you can dial in magnification for your own trouble spot(s). True, a professional examination and hardware is the ideal, but also expensive as hell.
An over-the-counter one can have knobs/sliders similar to:
1. Overall volume
2. Frequency of spike 1*
2A. Height of spike 1 (spike volume)
2B.
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This is true, and you can't just buy either hearing aids or glasses (legally) without a prescription.
And in both cases, I think people ought to be able to skip the doctor and find their own pair of hearing aids, or glasses, that work for them. When you go to the reading glasses kiosk in any store, you can tell if the glasses work for you, because you can read. All the fine-tuning and visual field mapping that a doctor does, goes on a chart, but doesn't do much else for you.
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I think that you are suffering from a sort of emotional sunk cost fallacy, that there was value in what you received and were not conned
It has been possible to purchase hearing aids from Germany that are equal in every way to US hearing aids for 1/10th what you would pay in the US
The only service needed is a competent plastic mold maker and somebody to tune the thing, certainly not skills that require a medical license
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As a long-time hearing-aid wearer, you've spent a lot of time talking to audiologists, who of course will give you all kinds of reasons why you need their services.
Of course, the circuitry for hearing aids differs from regular ear buds. But once the engineering is done and signed off by the FDA, the cost to make them is really no different.
If you were actually right, the FDA wouldn't be making this move.
End of a long-time scam (Score:5, Insightful)
This is a great change. The previous government rules -- lobbied and strongly supported by a small group of manufacturers -- were that the only way to get a hearing aid was to visit one of their "clinics" and pay several thousand dollars for the appliances they sold. There was virtually no competition and no pressure whatsoever to price this stuff competitively.
There is really no reason for oversight in dispensing these things, as they are not capable of causing any harm to the user and users are more than capable of telling whether it is working or not.
What do other countries do? (Score:2)
Why is this going to change technology suddenly? Does every other country in the world support regulatory capture and near monopolies by hearing aid companies? Isn't there a chance something better already exists?
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Check it out [nanohearingaids.com]
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What I want to know, based on the four or five people I've known over the years, is how these things get out of whack/require adjustment so frequently. Do people's hearing really swiftly change that much under normal circumstances?
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> Why is this going to change technology suddenly? Does every other country in the world support regulatory capture and near monopolies by hearing aid companies? Isn't there a chance something better already exists?
It does (you can get them on eBay) but Americans like to optimize the shit out of everything.
It's mostly cultural and cultural bias on personality development (little respect for authority).
China is catching up fast, but they still send their graduate students to the US in large numbers.
German
Mould oder in flour (Score:2)
What?
Finally! (Score:2)
The great thing about this is now the retail market can take over and make the ones that really serve customers needs, like the ones that have full equalizers on board that we can just adjust in real time.
The people who suffer from an audiogram gap - aka "cookie bite hearing loss" - have been waiting for this for AGES. The more specialized your hearing loss is, the better this is for access for you to the tools you need to hear again as best as tech can help.
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What? (Score:2)
Why haven't I heard of this sooner?
Marital Aids Are Sold Without Special Fitting : ) (Score:2)
Cost? What cost? (Score:2)
Great, but doesn't mean much. (Score:2)
The biggest change this will
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So, go to an audiologist to get the test, then to an autician(?) to get your hearing aid properly configured.
Just like you go to optometrists to discover exactly what correction your eyeglasses need to provide, and then any optician can sell you a pair.
>You need something that goes in your ears and plays tones at various frequencies.
You mean like... a hearing aid? Maybe even the exact same hearing aid you're using?
If they can connect with the phone (wirelessly or otherwise) it's not exactly hard to play
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I could be wrong, but I believe they are actually required by law to release your medical records to you on request - which includes your latest prescription. Though if they're assholes they may attempt to deny that, and make you jump through lots of hoops first.
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It's kind of pointless to just sell the hearing aid if you don't have good test kits. A phone app doesn't cut it. You need something that goes in your ears and plays tones at various frequencies.
You mean like the hearing aid?
You also need to make sure it's truly hearing loss and not something like auditory processing disorder [wikipedia.org] which is usually found in children with things like ADHD or ASD; but could also come from concussion or other brain injury.
That's fine, but probably 99% of hearing aids are used by the elderly, and in those cases, it's almost always truly hearing loss.
I'm all for bringing costs down and breaking what sounds like a monopoly; but let's make sure we do it right. These things should be required to come with some warnings and other information about what they can and can't do.
There are lawyers involved. It's safe to say there will be warning labels. Lots and LOTS of warning labels. :-D