The Science of Nuance: Dr. Douglas Beck Explains Nuance Audio Glasses

What if there was no stigma associated with hearing aids? What if your glasses could help you hear better? That’s the goal of Nuance Audio Glasses—a new FDA-cleared over-the-counter (OTC) hearing aid designed to improve speech clarity while eliminating the stigma of traditional hearing devices.

We spoke with audiologist Douglas L. Beck, AuD, to gather his thoughts about how they work, why he joined the company, and what the new studies reveal about their real-world, functional benefits.

Dr. Beck, who has devoted decades to shaping our understanding of hearing healthcare, recently joined Nuance Audio. A prolific author, clinician, and researcher, he served as the original Editor-in-Chief at AudiologyOnline, Web Content Editor for the American Academy of Audiology (AAA), and held the role of Vice President of Academic Sciences at one of the world's largest hearing aid manufacturers. Therefore, when Dr. Beck recently became Senior Director of Audiology for EssilorLuxottica, North America Inc., our curiosity was piqued.

In February 2025, Dr. Beck and Dr. Tami Harel-Arbeli, Chief of Audiology at Nuance Audio, published details about three pilot studies regarding Nuance Audio’s performance in the February edition of the Journal of Otolaryngology-ENT Research (JOENTR).¹

This prompted us to sit down with Dr. Beck and discuss how this new hearing device form factor (hearing glasses) may help overcome the cosmetic stigma associated with traditional hearing aids, and review some of the science and outcomes behind this new OTC hearing aid.

HearingTracker: Doug, I’ve known and worked with you for about 25 years, and you’re not someone who jumps onto trends lightly. What was it about Nuance that attracted you?

Dr. Douglas Beck: Well, there were quite a few things, but let me give you some context. After I left the hearing aid industry, I worked in cognition and cognitive science, all of which was fascinating and fruitful. During that same time period (2022-2024), I was approached by a few over-the-counter (OTC) hearing aid manufacturers to see if I would try their OTC product. Their idea was that if I liked it, perhaps I would speak on their behalf. I also found a few OTCs that I wanted to try, and I asked them for samples.

By the middle of 2024, I had tried seven or eight different OTC products. As a wearer of IICs and mini-RITE prescription hearing aids, the OTCs I tried lacked the quality of sound or the ability to substantially improve speech in noise. Frankly, I couldn’t and wouldn’t recommend anything that I wouldn’t wear, and so that was the end of that.

In late 2024, I was invited to try Nuance Audio Glasses. From the moment I put them on, I was impressed. They had very effective beamforming, three levels of noise reduction, five volume levels, omni and directional settings, nothing in the ear, and they were rechargeable—and importantly, they don’t look like hearing aids, they look like a pair of glasses. I was hooked.

I learned later that they can come with high-quality Transitions Gen S lenses already installed, so they get darker when you go outside and lighter when you’re inside, and they retail for around $1200—which is about half of what you’re going to pay for a premium set of OTC hearing aids, or about one-fifth the price of premium prescription hearing aids.

After that, I met with Tami Harel-Arbeli, Chief of Audiology at Nuance Audio. I learned about the research studies they had conducted, and that was what really attracted me.

The functional clinical outcomes for Nuance Audio are excellent.

HearingTracker: Tell me about the validation studies that you and Dr. Harel-Arbeli detailed in JOENTR. The first one focused on Speech-in-Noise (SIN) testing, right?

Dr. Beck: Yes, the SNR-50—which is the signal-to-noise ratio (SNR) required to correctly repeat half the words—is one of the most widely accepted ways for evaluating hearing in noise. To me, SIN assessments are on the precipice between objective and subjective assessments, although there are many opinions on that!

The SNR-50 tells us how much louder speech needs to be than background noise for someone to understand 50% of the words. A smaller SNR-50 indicates a better ability to understand speech in noise; a larger number indicates a greater challenge. People with relatively normal hearing and listening ability might have an SNR-50 of about 1, 2, or 3 dB, meaning the primary speech signal must be 1, 2, or 3 dB louder than the competing background noise for the subject to repeat 50% of the words correctly. However, people with a mild-to-moderate hearing loss might need an SNR-50 of 7, 8, or 9 dB.

Every 1 dB SNR improvement is generally thought to improve word recognition by about 8-10% in typical listening situations.^2,3 As such, a 3.5 dB improvement in SNR may provide a substantial improvement in real-world speech understanding for most people with a self-perceived mild-to-moderate hearing loss.

Further, the excellent beam-forming result comes from the use of 6 microphones and advanced processing. The Nuance research team ran tests comparing Nuance Audio Glasses to two premium prescriptive hearing aids from the major manufacturers with 19 study participants. Nuance Audio delivered an average 3.5 dB improvement in SNR-50 scores, which is a significant improvement, and Nuance Audio performed on average better than the two prescription products. Functionally, a 3.5 dB average improvement in SNR-50 is something most users notice immediately.

As you’ve seen on many YouTube videos, as soon as someone wears Nuance Audio they get an “aha moment,” a smile, and they start turning their heads to see where all the sounds are coming from. Then, once they’re calibrated for “own voice” and microphone/speaker differentials, the devices sound even better. Of course, this is exactly what happens when people wear prescription hearing aids prior to programming. Patients often say their voice sounds like they are talking in a barrel, and so we program prescription hearing aids to remove that problem, as we do with Nuance Audio.

The number-one complaint that hearing care professionals address daily is speech clarity. Patients report “speech is not clear,” or “people mumble,” or “it’s hard to understand speech in noise.”

As such, the goal of an appropriately fit, modern hearing aid is to make sound clearer, and the best way to do that is to improve the SNR. As you know, in addition to the JOENTR article, HearAdvisor.com rated Nuance Audio Glasses in the top-third of all devices they tested and above 87 other hearing aids for speech-in-noise performance, which included both OTC and prescription hearing aids.

Regardless, Nuance Audio was awarded a Sound Grade of “A” (rated 4.1 of 5) and an Expert Choice Award, placing it in the same “A” category as Starkey Edge AI RIC, Jabra Enhance Pro 20, Starkey Evolve AI, Signia Styletto AX, Widex Moment Smart RIC, Phonak Audeo Lumity, Oticon Real, More, and Intent, Phonak Sphere Infinio, and others. We’re extremely happy and proud to be in the company of some of the most well-respected brands and models of modern hearing aids.

HearingTracker: I agree that’s impressive. And the second report you and Dr Harel-Arbeli wrote about was more qualitative?

Dr. Beck: Yes, it was. The researchers asked 43 people who had trouble hearing in various listening environments to rate the performance of Nuance Audio Glasses in simulated real-world environments. The statements and question were very simple:

1. I can hear conversations “clearly” with the glasses.
2. Sound quality is good, without adverse effect, and
3. Did you feel a change in listening effort while using the glasses?

The overwhelming majority said “yes” to statements 1 and 2.  Speech clarity and overall sound quality had a median of 5 (i.e., “completely agree”) while the listening effort question resulted in a median of 4 (“better”).

HearingTracker: I appreciate the straightforwardness of that. It’s a reminder that at the end of the day, functionality matters more than lab precision. Functional hearing ability is always the ultimate goal—very much in line with what experts like Dr. Jane Madell have been teaching us for decades!

Dr. Beck: Exactly. Verification via electroacoustic test boxes and probe-mic measures is very valuable and offers significant insight into the fitting of traditional form-factor hearing aids. I’ve been promoting both of these verification tools for decades. However, despite objective success, if the user doesn't experience better hearing, listening, and communication, then it’s back to the drawing board.

That’s why we rely heavily on functional outcome measures like speech-in-noise assessments and communication and listening questionnaires, which is where Nuance Audio excels: validation from users. We focus on how the individual is doing in their real-world, day-to-day listening situations. We ask “Is conversation easier” and “Is it easier to hear and listen?”

Personally, I firmly believe that hearing aid stigma is the real 800-pound gorilla. Earlier this week, I read a new report (2024-2025) from the British Irish Hearing Instrument Manufacturers Association (BIHIMA). They asked their hundreds of members if there is a stigma about hearing tests and wearing hearing aids. They reported that one-third said "Yes,” hearing aid stigma is still significant, and some two-thirds said "Yes,” it is, but stigma is declining.

My interpretation of their study was 95% said yes, stigma is still an issue, and of course, all one has to do is Google “hearing aid stigma,” and there is lots of confirmatory evidence.

HearingTracker: And finally, the third study the two of you reported on looked at the International Outcomes Inventory for Hearing Aids (IOI-HA) outcomes, right?

Dr. Beck: Correct. The IOI-HA is a simple, validated, tried-and-true test that provides a lot of valuable insights.⁴ It has long been among my favorite listening and communication assessments. It asks users to rate their experience across seven different domains: device use, benefit, satisfaction, residual activity and participation limitations, impact on others, and quality of life.

Users rated Nuance Audio Glasses above average for published norms of prescription hearing aids in 5 of the 7 categories, including use, satisfaction, residual activity and participation limitations, and impact on others. For the final two categories, Nuance didn’t have a significant difference from the published norms for prescription hearing aids.

It suggests that people aren’t just hearing louder while wearing them, they experienced improvements in their hearing, listening and overall communicative ability, which allows them to socialize more, understand more, participate more, and stay socially engaged.

HearingTracker: In other words, it's not just “Do I hear it louder?” but “Do I function better in my daily life?”

Dr. Beck: Precisely. And that’s what matters most.

HearingTracker: You’ve said the biggest barrier to hearing aid use might not be accessibility or affordability—but stigma. Why do you think hearing glasses are such a breakthrough?

Dr. Beck: Going back to the FDA discussions and their October 2022 ruling, I think it’s fair to say their work focused on overall safety as well as overcoming impediments to hearing aid acquisition, which they primarily identified as access and affordability. In my opinion, access in 2025 is largely solved. You can buy OTC hearing aids from tens of thousands of brick-and-mortar locations and, of course, online.

Affordability has also improved, although arguably not as much as I would have expected. Premium OTC devices still cost between $1500 and $2800 per pair.^5,6

As noted above in the BIHIMA report, hearing aid stigma exists and it plays a massive role in the seek-and-purchase behaviors of people with hearing loss. We’ve been telling patients for decades things like “your hearing aids aren’t as visible as your hearing loss” and we’ve been pushing the standard hearing aid form factor like a boulder up a hill for a long time. Although traditional form-factor hearing aids have incredibly sophisticated sound processing, they work extraordinarily well, and they have very high satisfaction ratings, relatively few people want to wear them!

The contemporary literature indicates 85% of people who would likely benefit from hearing aids do not seek them. To me, that’s the traditional form factor speaking loud and clear. I think everyone wants to be able to hear and listen as clearly as possible, yet very few people want to wear hearing aids.

Although access and affordability are very important, to me, the primary issue is hearing aid stigma. Unfortunately, hearing aid wearers are often perceived as older than they are, less competent than they are, and they are viewed as different—all of which is grossly unfair, inappropriate, and highly regrettable, but that is what the literature suggests.

The bottom line is our appearance and cosmetics matter a lot, and I’m not speaking just about hearing aids. I queried AI for current information and here is what I learned: Some 45 million people in the United States wear contact lenses, some 17.5 million people globally wear Invisalign braces, 7 million people in the USA had botox injections in 2023, and of course, people seek hair implants, wigs, toupees, and one might ask, why wear make-up?

It seems clear to me that, when possible, people want to look their best, and I don’t see anything wrong with that. Regarding traditional hearing aid form factors, people seem to prefer to avoid them. Nuance Audio Glasses completely remove that stigma. They look like fashionable eyewear.

HearingTracker: Are they meant to be worn all day?

Dr. Beck : They have a rechargeable battery life of about 8 hours, which depends on the listening environment and the level of processing required. I wear mine whenever I’m around people—meetings, social settings, restaurants. I turn mine off when I’m reading, writing, driving, etc.

As long as I’m strategic about turning them on and off, mine last all day. When I turn them off at home or in my office, I place them on the charging pad for 60 minutes and they're good to go.

Keep in mind that OTC hearing aids are primarily designed to help people who have self-perceived mild-to-moderate hearing loss, and these people may or may not be working with a hearing care professional. I think OTC candidates often want help in specific situations like business meetings, family gatherings, restaurants, cocktail parties, and similar challenging situations, so Nuance Audio offers an excellent and readily acceptable solution.

Also consider the most successful hearing technology of all time: Apple AirPods have sold more than 150 million units. However, after a few hours of streaming, they run out of battery life; they bottom out. Yet, 150 million have been sold and people wear them as needed or as desired. That’s a huge endorsement for the idea that people can and will wear hearing technology as desired or as needed, or situationally.

HearingTracker: Who do you think would benefit most from Nuance Audio Glasses?

Dr. Beck:  As an FDA-cleared OTC hearing aid, Nuance Audio has the potential to help adults with self-perceived mild-to-moderate hearing loss, which is probably 75-85% of all people with hearing loss. At the very least, Nuance Audio can get people onto an effective hearing treatment pathway much sooner than in the past—when the average person often waits about 10 years before taking action on their hearing loss.⁷

Nuance Audio is ideal for people who have specific hearing difficulty in challenging situations like restaurants, family gatherings, and cocktail parties. Many people do not want the expense of prescription hearing aids and professional services, and they are likely to be concerned about hearing aid stigma— they don’t want anything in their ears.

Yet, I’ll bet the majority would appreciate hearing and listening better if they didn’t have all those trade-offs. My thought is Nuance Audio Glasses wearers will likely realize the benefits of high-quality amplification, and I suspect many will go on to acquire prescription products at a later time, after they realize the benefits of sophisticated amplification.

HearingTracker: Do you think other major hearing aid manufacturers might eventually enter the hearing glasses space?

Dr. Beck: I wouldn’t be surprised. Hearing Aid Glasses were the standard form factor almost a 100 years ago, as they were for decades. After World War II, the market changed, and it changed again after President Reagan wore his custom-made in-the-ear devices.

In 2025, we have micro technology and tremendous benefits from advanced processing—so what’s old is new again! However, as a new OTC hearing aid category, Hearing Aid Glasses certainly hold great promise for many people, and it wouldn’t surprise me at all if others entered the market.

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Editor’s note: For more technical details on the validation studies, see the open-access article by Beck and Harel-Arbeli in the Journal of Otolaryngology-ENT Research. You can also visit the Nuance Audio website for information.