From the Guidelines
Tinnitus following eye surgery should be evaluated and managed by a healthcare provider, with a focus on cognitive behavioral therapy (CBT) as a recommended treatment option, as stated in the clinical practice guideline: tinnitus executive summary 1. The initial step in managing tinnitus post eye surgery is to consult with the ophthalmologist who performed the surgery to determine if there's a direct connection between the procedure and the tinnitus symptoms. Some key points to consider in the management of tinnitus include:
- Treatment options such as sound therapy using white noise machines or smartphone apps to mask the ringing sensation
- Medications like low-dose antidepressants (e.g., amitriptyline 10-25mg before bedtime) or anti-anxiety medications (e.g., alprazolam 0.25-0.5mg as needed) for short-term relief
- Avoiding potential tinnitus triggers like caffeine, alcohol, and aspirin products
- Referral to an otolaryngologist (ENT specialist) for comprehensive evaluation, including hearing tests, if symptoms persist According to the American Academy of Otolaryngology and Head and Neck Surgery Foundation (AAO-HNS) guidelines, education and counseling are also essential in managing tinnitus, as they can help patients understand the condition and its management strategies 1. The most recent guidelines from the American College of Radiology (2023) emphasize the importance of targeted history and clinical examination in the initial evaluation of tinnitus, and recommend against imaging studies for patients with nonpulsatile tinnitus that does not localize to one ear and is not associated with focal neurological abnormalities or asymmetric hearing loss 1. Overall, the management of tinnitus post eye surgery requires a comprehensive approach that takes into account the patient's overall health and well-being, and CBT is a recommended treatment option that can help improve quality of life 1.
From the Research
Treatment of Tinnitus
- Tinnitus is a common problem encountered in primary care, and most cases are benign and idiopathic, strongly associated with sensorineural hearing loss 2.
- A standard workup for tinnitus begins with a targeted history and physical examination to identify treatable causes and associated symptoms that may improve with treatment 2.
Management of Tinnitus
- Cognitive behavior therapy (CBT) is the only treatment that has been shown to improve quality of life in patients with tinnitus 2, 3.
- Mindfulness-based cognitive therapy (MBCT) has been found to be effective in reducing tinnitus severity and psychological distress in chronic tinnitus patients 4.
- Yoga and meditation may have a positive effect on tinnitus, reducing severity, stress, anxiety, and irritability, and improving quality of life 5.
- Refined sound therapy combined with CBT may be more effective than post-auricular injection of lidocaine and methylprednisolone sodium succinate in treating tinnitus and improving psychological symptoms 6.
Treatment Options
- Sound therapy and tinnitus retraining therapy are treatment options, but evidence is inconclusive 2.
- Melatonin, antidepressants, and cognitive training may help with sleep disturbance, mood disorders, and cognitive impairments, respectively 2.
- Avoidance of noise exposure may help prevent the development or progression of tinnitus 2.