Adults with hearing impairment are significantly less likely to achieve meaningful functional improvements from vision rehabilitation, according to a new study.
The cross-sectional analysis examined 611 adults receiving outpatient low vision rehabilitation services across 28 clinical centres in America.
Drawing on data from the Low Vision Rehabilitation Outcomes Study, researchers found that while baseline visual function was similar regardless of hearing status, those with hearing impairment were less likely to experience clinically important gains after (vision) rehabilitation.
The researchers, from Wilmer Eye Institute at Johns Hopkins University, and Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland published findings online in JAMA Ophthalmology on 12 March 2026.
Overall, 31% of participants with normal hearing achieved a minimum clinically important difference (MCID) in functional ability, compared with just 23% of those with hearing impairment.
After adjusting for demographic and health-related factors, hearing impairment remained independently associated with a reduced likelihood of improvement.
Findings suggested that dual sensory impairment – coexisting vision and hearing loss – may limit the effectiveness of conventional rehabilitation approaches, which typically focus on a single sensory modality.
“Individuals with dual sensory impairment face unique challenges that are not well addressed by standard rehabilitation models,” the authors said. “Our results highlight the need for more integrated, interdisciplinary strategies.”
The study cohort had a mean age of 73 years, reflecting the higher prevalence of sensory impairments in older populations. Overall, 253 participants reported hearing impairment at baseline. Follow-up data was available for 407 people.
The association between hearing impairment and poorer outcomes was not mitigated by hearing aid use, researchers said.
They said participants with hearing loss who owned hearing aids were no more likely to achieve functional gains than those without them, suggesting that amplification alone may be insufficient to overcome barriers posed by dual impairment in a rehabilitation context.
The primary outcome measure was change in general functional ability, assessed using the Activity Inventory, a patient-reported tool widely used in low vision care.
Rehabilitation was deemed successful if participants reached an MCID, indicating a meaningful improvement in daily functioning.
The analysis also found that participants with more severe vision impairment were more likely to achieve clinically significant gains as were those with higher levels of depressive symptoms.
The latter finding may reflect greater potential for improvement or increased engagement with rehabilitation services among those experiencing more pronounced challenges, researchers said.
They said dual sensory impairment was common in ageing populations and associated with increased risks of social isolation, reduced independence, and poorer quality of life. But evidence on how best to rehabilitate this group remained limited.
“Our findings underscore the importance of considering hearing status when planning and delivering vision rehabilitation,” they said. “Programs that integrate hearing and vision care, or that adapt communication and training methods for people with hearing loss, may improve outcomes.”
The researchers said that, for clinicians, the study reinforced the need to screen for hearing impairment in people presenting for vision rehabilitation and to consider multidisciplinary approaches.
For service providers and policymakers, it added to growing evidence that siloed care models may fall short for patients with complex, overlapping sensory needs.
The authors said rethinking rehabilitation frameworks would be critical to maximising functional independence and quality of life for affected individuals as populations age and rates of dual sensory impairment rise.