Medical Accessories in Passport Photos 2026 – Hearing Aids, Tubes, Glasses

ICAO Doc 9303 does not explicitly list every type of medical device. Instead, it establishes the overarching rule: the photo must be a “true likeness” of the holder as they appear at the time of use. This means:

• If you wear a hearing aid every day, you should wear it in your passport photo — because that is how you actually look.
• If you depend on an oxygen tube or nasal cannula, that is part of your daily appearance and should be included, subject to the face remaining visible.
• If you are wearing equipment temporarily (post-surgery glasses for a short period), this creates a harder case — a temporary appearance may not represent your long-term likeness.

The key test applied by border officers and automated systems: does the photo clearly and accurately identify the person presenting it? Medical accessories that are permanent, daily-worn parts of your appearance should be in the photo for exactly this reason.

In-ear (ITE/CIC) hearing aids sit inside the ear canal and are largely invisible in a passport photo. They do not present any compliance concern.

Behind-the-ear (BTE) hearing aids have a visible component that sits over the ear. These are allowed if worn daily, with two practical considerations:

• The device should not create unusual shadows on the face or ear area. Good diffused lighting minimises this.
• The ear itself should remain visible — particularly the ear outline, which some biometric systems use as a secondary feature.

Cochlear implant external processors are more visible devices worn on or near the ear. The same principle applies: allowed if worn daily, and must not obscure the face. The processor sits behind the ear or at the side of the head — it should not be visible over the face in a front-facing photo.

People who rely on supplemental oxygen continuously face a specific challenge: a nasal cannula passes under the nose and over the upper cheeks, sitting in the biometrically significant central face area. Different authorities approach this differently:

• ICAO principle: If worn continuously, it represents the person's true likeness and should be included.
• Practical authority position: Many national authorities will accept the photo but may require a letter from a medical professional confirming the continuous requirement.
• What the photo must still show: Both eyes fully open, the nose bridge clearly visible, and the overall face clearly identifiable. Tubes that significantly obscure the face may require repositioning or a different photo angle.

Before your application, contact your national passport authority directly to confirm the procedure. Many have specific guidance for applicants with permanent medical equipment.

This is the most common question in this category. The answer is specific: glasses are banned because they physically obstruct or distort biometric facial data.

• Lens reflections: Glass and plastic lenses create light reflections that obscure the eye area — the most biometrically significant region of the face.
• Tint and colour: Even clear lenses can alter the apparent colour of the eyes and surrounding area under certain lighting conditions. Tinted or photochromic lenses are particularly problematic.
• Frame obstruction: Eyeglass frames cross the biometrically critical brow-to-pupil and inter-pupil distance measurement zones.

A hearing aid, by contrast, sits at the ear — well outside the facial measurement zones used by biometric systems. The same logic applies to cochlear implants. This is why the rule is consistent: anything in the face area that could obstruct or distort biometric measurement is banned, regardless of whether it is a fashion choice or a medical necessity.

Prescription glasses: There is no medical exemption to the glasses ban. A person who genuinely cannot function without glasses must still remove them for the photo. If you have had recent eye surgery and cannot safely remove glasses temporarily, contact your passport authority for their specific procedure.

Medical eye patch (permanent): Allowed if the eye patch is a permanent part of your daily appearance. At least one eye must be clearly visible. Authorities may require documentation for an unusual accessory.

Cervical collar / neck brace: Generally allowed if medically necessary and worn daily. The face must remain fully visible and the head must be upright and facing forward (ICAO head position requirement). If the collar affects your ability to hold the required head position, contact your passport authority in advance.

Tracheostomy: If the device is external but below the face area, it generally should not affect the photo. The face must be clearly visible. Contact your authority for specific guidance.

Medical head covering (alopecia, chemotherapy): Medical head coverings are treated under the same rules as religious headwear. They are permitted if the full face remains visible.

If you need to include medical equipment in your passport photo that is not a simple case (like a hearing aid), the safest approach is to contact your national passport authority before submitting:

• UK (HMPO): Contact via the HMPO enquiries line or the overseas passport section of a consulate.
• Germany: Contact the Bürgeramt handling your application. For specific medical cases, they can advise on documentation requirements.
• Switzerland: Contact the Einwohnerkontrolle or Gemeindeverwaltung.
• USA: Contact the US State Department Passport Services or a regional passport agency.
• Schengen visa applications: Contact the specific embassy or consulate processing your application.

Having a brief letter from your doctor describing the medical necessity of the accessory is useful in all cases where the requirement is not immediately obvious.