Vision and Hearing Health: Vital to Military Readiness

Story by Ken Cornwell

Defense Health Agency

Military health experts say vision and hearing health are crucial to mission readiness and success, both on and off duty.

“Humans rely on their hearing every day to interact with the world,” said Laurel Alstot, an occupational audiologist and hearing conservation program manager working for the U.S. Navy. “But the military is specifically an environment where the need to understand spoken commands, identify and localize sounds, and respond to audible signals is not only ubiquitous but often time sensitive.”

Vision and hearing are connected to your awareness of the environment around you, as well.

“Your brain is designed to integrate the information it receives from the peripheral senses to create a complete and detailed picture of your environment and any potential dangers around you,” said Alstot.

Good hearing is vital, she continued. “Not only to the perception of one’s environment, but also to the ability to respond to changes quickly and accurately within it. Service members in all branches rely on their hearing to stay safe and accomplish their mission successfully.”

Military jobs have a high rate of what we call “hearing-critical tasks,” Alstot said. Hearing critical tasks are tasks in which hearing is the only sense that can perform those tasks.

“These are tasks in which speed and accuracy of identifying, locating, interpreting, and responding to sounds are essential to their success. There’s a wide variety of critical tasks in the military—things like understanding mission briefs, receiving information on troop movements, or geographical locations. Even field injury reports.”

U.S. Navy Cmdr. Micah Kinney, a U.S. Navy aerospace optometrist, said vision health is equally important to accomplishing the mission as hearing health. “Visual cues influence our spatial orientation … and our senses provide important information relative to our position.”

This is particularly important for service members in the aviation profession, he said.

“Our eyes tell our brain if we are straight and level in three-dimensional space. We can also gauge speed and motion based on visual input,” he said. “This is often without us even knowing we are sensing it.”

“The next time you’re in the car on the highway, take a minute to realize how much you’re using your visual system in traffic—peripheral cues, speed cues, lane changes. The vestibular system, part of our inner ear, helps provide information on our physical motion through space,” Kinney explained. “As service members learn to hone and interpret their senses, they can move and process information in dynamic environments which will help in quick decision-making and situational awareness.”

Situational awareness is your understanding not just of environmental surroundings, but specifically of changes within them, added Alstot.

“Our brains are highly attuned to changes in our environment,” she said. “That’s why an unknown sound will capture attention, even if we’re not consciously aware of it. Our brain is always receiving information from our ears—not only the type of sound but the direction and distance of a sound.”

“Ears and eyes are tied together,” continued Alstot. “The underlying mechanism of the vestibular system is linked directly through muscle and nerve control to the eyes. It’s just one of many auditory and visual connections.”

When ears or eyes are not functioning, your brain reroutes your body’s resources, said Alstot.

“We can see the integration of sensory input for situational awareness in functional MRI scans of the brain of a person who is hearing impaired. These scans show that resources start to be allocated to vision and to other areas because your brain is trying to compensate.”

How Vision and Hearing Health Promote Service Member Readiness

Visual health is more than just reading 20/20 on an eye chart, said Kinney.

“More than 50% of our brain’s processes are integrated with the visual system. A dilated eye exam can discover undiagnosed systemic diseases like diabetes, hypertension, high cholesterol, tumors, multiple sclerosis, to name just a few conditions,” he said. “It is important for service members to know that even if you do not need corrective lenses like contacts and glasses, a routine eye exam to check on your eye health is still important to preserving your vision.”

Audiologists monitor service members for hearing loss that can affect mission readiness and performance, noted Alstot, saying, “All branches have hearing requirements… which includes an entrance and termination audio exam for all service members. Marines and soldiers are required to have annual audiograms to check for hearing declines, while airmen and sailors require annual hearing tests only if they are enrolled in the Hearing Conservation Program or have jobs that have specific hearing standards.”

“Hearing loss impacts our situational awareness by decreasing our ability to sense changes in the environment and impairing our ability to understand and process the incoming information,” she said. “This is obviously a grave safety risk in something like a combat situation, but it also poses a safety risk in environments like engine rooms and around heavy equipment.”

Kinney has observed in his own patients how optometry and visual health have a positive impact on mission readiness and service member health.

“Early in my career, I had a patient with diabetic complications in the eye and another patient with thyroid eye disease. This taught me that even though our military population is generally young and healthy, there are service members out there who may not know they have a systemic health problem until they come in for an eye exam.”

These are just a few of the reasons why protecting service members vision and hearing should be just as important as dental readiness and other medical requirements, said Kinney.

“As we look to ‘get real and get better’ with the delivery of quality health care for our service members, having a regular interval comprehensive eye exam should be considered,” he said. “In the optometry community we say, ‘vision ready is mission ready.’ If we can’t see, we can’t fly, shoot, or win.”