Gabrielle H Saunders
Trustee and Member, Adult Rehabilitation Interest Group, British Society of Audiology
Rebecca E. Millman
Chair, Cognition in Hearing Special Interest Group, British Society of Audiology
Sudhira Ratnayake
Trustee, British Society of Audiology
Someone with dual sensory loss (DSL) has problems with both their hearing and eyesight (hearing loss and vision loss). It is also known as ‘deafblindness’. This doesn’t mean the person is totally deaf and totally blind, just that both senses are affected.
DSL has major effects on people’s health, wellbeing, quality of life and independence because it affects ordinary daily activities, like shopping and going to the doctor (which mostly use vision) and social activities like chatting to friends and family (which mostly uses hearing).
Causes of DSL
The condition can affect people of all ages and for many reasons. Babies can be born with DSL (congenital DSL) due to rare genetic conditions or complications during pregnancy – such as a mother catching rubella when pregnant. It can also be caused by genetic conditions like Usher syndrome, by an illness like meningitis, or even a severe head injury. Most commonly though, DSL happens gradually as we age and so it is much more common in older people.
The number of people with DSL varies greatly across the world because of differences in the availability of healthcare that can prevent or cure eye and ear diseases.
More effects that one condition alone
It is often said that with DSL ‘one plus one is more than two’, meaning that the negative effects of DSL add up to more than the effects of vision loss only and hearing loss only. There is a good reason for this – because we usually use our eyes when our ears aren’t working well and vice versa. This isn’t possible for someone with DSL.
For example, when it is hard to hear we look at the face and lips of the person speaking or use subtitles when watching the TV – but if someone has poor eyesight, the benefit they get from these cues will be limited. Similarly, someone with poor eyesight can get a talking watch to tell the time or use a text-to-speech app to listen to books – but can’t use these if they have poor hearing.
Support is available
Because of this, people with DSL can have a hard time during school, finding employment and managing the home. This can result in them feeling lonely, isolated and depressed. However, there are many organisations that specifically provide support and help for people with DSL or deafblindness.
Organisations like the National Center on Deaf Blindness, RNIB, Sense, WFDB and Deafblind International all have great resources that can help support those in need.
[1] Tseng YC, Liu SH, Lou MF, Huang GS. Quality of life in older adults with sensory impairments: a systematic review. Qual Life Res. 2018 Aug;27(8):1957-1971. doi: 10.1007/s11136-018-1799-2. Epub 2018 Feb 5. PMID: 29404924.
[2] World Federation Global report 2018. At risk of exclusion from CRPD and SDGS implementation: Inequality of persons with deafblindnes. Available at: https://wfdb.eu/wfdb-report-2018/
[3] Saunders GH, Echt KV. An overview of dual sensory impairment in older adults: perspectives for rehabilitation. Trends Amplif. 2007 Dec;11(4):243-58. doi: 10.1177/1084713807308365. PMID: 18003868; PMCID: PMC4111537./
[4] Hajek A, König HH. Dual sensory impairment and psychosocial factors. Findings based on a nationally representative sample. Arch Gerontol Geriatr. 2020 Aug 18;91:104234. doi: 10.1016/j.archger.2020.104234. Epub ahead of print. PMID: 32835870.
[5] Phua J, Visaria A, Østbye T, Malhotra R. Association of vision and hearing impairments with quality of life among older adults: Mediation by psychosocial factors. Geriatr Gerontol Int. 2022 Jan;22(1):56-62. doi: 10.1111/ggi.14318. Epub 2021 Dec 1. PMID: 34852404.
