Dr. Cliff's Review of Nuance Audio OTC Hearing Glasses

The concept of eyeglass hearing aids isn't new. Back in the 1950s and 1960s, these devices were relatively popular, including President Lyndon B. Johnson who wore them for his bilateral sensorineural hearing loss into the 1970s. However, as hearing aids became smaller and more convenient, eyeglass hearing aids fell out of favor and virtually disappeared from the market.

That changed in 2024 when Nuance Audio, in partnership with Essilor Luxottica, received FDA approval for their innovative eyeglass hearing aids. Dr. Cliff Olson recently completed an extensive review of these devices, and the results are fascinating for anyone considering this unique approach to hearing enhancement.

Who Are These Devices For?

The Nuance Audio eyeglass hearing aids are designed for adults with perceived mild to moderate hearing loss. As an over-the-counter hearing aid, they have amplification limitations that make them unsuitable for anything beyond moderate hearing loss levels. These devices are primarily targeted toward individuals who want to hear better in background noise situations, though they can technically be worn throughout the day.

Interestingly, Dr. Cliff's testing suggests that even people with normal hearing could benefit from wearing these glasses in noisy environments due to their advanced directional microphone technology.

Design and Features

The Nuance Audio glasses come in two styles: square and pantos, available in black and burgundy colors. The square design offers two caliber options (54mm and 56mm), while the pantos style comes only in 48mm. The frames cost $1,100, with additional charges for prescription lenses and upgrades potentially bringing the total to around $1,500.

What makes these glasses remarkable is their sophisticated microphone array. Six microphones are strategically placed throughout the frames - two forward-facing microphones on the front rivets, three additional microphones along the bottom of the right temple, and one on the left temple. This configuration creates a powerful directional system that can focus on sounds coming from in front of the wearer while reducing background noise from the sides and rear.

Unlike traditional eyeglass hearing aids that required tubes and custom ear molds, the Nuance Audio glasses use speakers positioned underneath the temples, directly in front of the ears. This design makes the temples slightly thicker than regular glasses but maintains a natural appearance that doesn't immediately identify them as hearing devices.

Performance and Battery Life

The glasses provide up to eight hours of battery life on a single charge, which is impressive compared to many wireless earbuds but may fall short for users who need all-day hearing assistance. The lithium-ion rechargeable batteries are housed within the temples, and the glasses automatically turn off when folded, helping preserve battery life.

A convenient charging pad is included, using USB-C connectivity. The glasses feature Bluetooth Low Energy compatibility with iOS 16 and Android 13 operating systems or higher, though they don't offer traditional Bluetooth streaming capabilities.

App Control and Customization

The Nuance Audio app provides comprehensive control over the glasses' functionality. Users can adjust background noise settings across three levels (lowered, standard, and heightened) and choose from four different presets designed for various hearing loss configurations:

• Preset A: Flat, very mild hearing loss
• Preset B: Normal sloping to mild/moderate high-frequency hearing loss
• Preset C: Mild sloping to moderate high-frequency hearing loss
• Preset D: Flat moderate hearing loss

The app also offers five volume levels and the ability to switch between frontal mode (directional) and all-around mode for different listening situations.

Clinical Testing Results

Dr. Cliff conducted extensive Real Ear Measurement testing to objectively evaluate the glasses' performance. Real Ear Measurements allow audiologists to verify that hearing aids are providing appropriate amplification by measuring sound levels directly in the user's ear canal.

The testing revealed that the Nuance Audio glasses performed best for flat, very mild levels of hearing loss. For anything beyond mild hearing loss, particularly in the high-frequency ranges, the glasses showed significant under-amplification compared to prescriptive targets. This limitation is partly due to the speakers being positioned above the ears rather than inside the ear canals like traditional hearing aids.

However, the directional benefit was impressive, showing a five-decibel improvement for sounds originating from in front of the user compared to sounds from behind, across frequencies from 750 Hz to 6,000 Hz. The noise reduction capabilities also performed well, with the "lowered" setting providing up to five decibels of noise reduction.

Research Support

Published research by Drs. Tami Harel-Arbeli and Douglas Beck, both affiliated with Nuance Audio, found that the glasses achieved up to a 4.4 decibel signal-to-noise ratio improvement. The study also indicated that the Nuance Audio eyeglass hearing aids could outperform prescription hearing aids in noisy settings for mild to moderate levels of hearing loss, primarily due to their superior directional capabilities.