The most direct effect of a hearing loss is the inability to hear soft sounds. Depending on the degree of the hearing loss, some people may have a hard time hearing conversational sounds or even loud sounds. Some people may hear speech sounds but they may not understand their meaning. This is referred to as impaired discrimination ability and is especially noticeable in noisy places. In addition, many people with a hearing loss also notice a constant ringing or rushing sound in their ears (tinnitus). Like vision loss, hearing loss is also a problem that affects the quality of life.