Vitiligo is most commonly known for affecting the skin by causing loss of pigmentation as a result of the immune system attacking pigment-producing cells, or melanocytes. But did you know that vitiligo may also impact hearing and vision? This is because those same melanocytes are not only found in the skin and hair but throughout the body, including in the eyes and ears.
Whether vitiligo affects the senses and how it may do this is a growing area of research, with evidence indicating that vitiligo can impact hearing and vision. However, that doesn’t mean that it will. Here’s what we know so far.
How vitiligo might impact hearing
Let’s start with the ears. Several studies have shown a link between higher rates of sensorineural hearing loss and patients with vitiligo. Sensorineural hearing loss refers to the loss of sound as it moves from the inside of the ear through the nervous system, which is then interpreted by the brain. A 2010 study reported some degree of sensorineural hearing loss in approximately 35% of patients with vitiligo, compared to only 16% in those without vitiligo in the same study.
To screen for sensorineural hearing loss, ask your doctor about a Weber test. A Weber test involves vibrating a tuning fork and setting it atop the middle of your head to see whether you hear best in one ear, the other ear, or equally in both. For a definitive diagnosis of any hearing changes, talk to your doctor about formal audiometry testing and consider seeing a hearing specialist.
How vitiligo might impact vision
Let’s talk about how we see the world—literally. Melanocytes are especially prominent in two regions of the eye, one of which is the all-important retina, which is essential to how we receive and transmit visual information. One study linked vitiligo to changes in the primary nerve responsible for input from the retina to the brain.
The other group of melanocytes are found in those parts of the eye that are important for protecting against pollutants in the air and sun damage. Without this protection, evidence suggests a 5% incidence of acute inflammation to these parts of the eye, or acute uveitis, in individuals living with vitiligo.
You can see an ophthalmologist to assess the impact of vitiligo on your vision.
Other factors that can contribute to vitiligo impacting hearing and vision
Sometimes vitiligo tags along with other autoimmune conditions or is part of a genetic syndrome—like Vogt-Koyanagi-Harada syndrome. This may also contribute to changes in hearing and vision. In these cases, vitiligo may not be the cause of hearing and vision changes but may be related to another disease.
For example, patients with vitiligo and comorbid hyperthyroidism, where the thyroid is overstimulated, can experience changes in their vision. Additional factors affecting whether someone living with vitiligo has hearing or vision loss include the subtype of vitiligo they have, sites of involvement, control of disease severity and age of onset.
Will vitiligo impact my hearing or vision?
Although hearing and vision changes may be identified by rigorous scientific testing, patients may not be aware of any symptoms. In fact, patients could have an unaffected quality of life. To date, the research is inconclusive as to the extent vitiligo impacts hearing and vision or if it affects these areas at all.
However, it may be important to identify vision and hearing changes prior to vitiligo treatment. Studies show that steroids and phototherapy can also affect the senses. It might be worthwhile to distinguish between the patient’s baseline and status post-treatment to determine whether vitiligo or the treatment is impacting the senses.
If you are worried about whether vitiligo is impacting your vision or hearing, please schedule an appointment with a medical professional.
What has been your experience with vision and hearing and how it relates to your vitiligo?
Disclaimer: This list is provided for informational purposes only. Please consult your dermatologist to determine the best treatment options for you.
A third-year medical student at Northwestern University Feinberg School of Medicine, Ali Khan has dedicated himself to projects that disseminate scientific information. Ali graduated from college with a BA in English and completed a scholars program to pursue a tuition-free fifth year of immersion in behavioral health. Ali spent a gap year after college at the National Institutes of Health in Bethesda, MD, where he bridged basic science and community education by being involved in both basic science research and serving as a NIH Academy fellow to carry out a community health education effort.