Ear examination

An ear exam may be done:

• to find the cause of ear pain, a feeling of pressure or fullness in your ear or hearing loss.
• if your healthcare provider suspects you have an ear infection, to find where it is – the infection may be in the external ear canal (otitis externa), or it might be in the middle ear behind the eardrum (otitis media)
• to check for objects, lumps or too much earwax
• if you've had a head injury
• to see how the treatment for an ear problem is working.

What instrument is used?

To examine the inside of your ear (the ear canal and the eardrum), your healthcare provider will use an instrument called an otoscope (this can also be called an auroscope).

• An otoscope is a handheld tool with a light and a magnifying lens (see image below).
• It has a removable plastic tip shaped like a cone that allows the healthcare provider to look inside your ear. 
• A pneumatic otoscope has a rubber bulb that your healthcare provider can squeeze to give a puff of air into the ear canal. The air helps them see how the eardrum moves.
• They might use a tympanometer. It looks like an otoscope but instead of being used to look in your ear, it sends a puff of air down your ear canal and gives a reading of your ear drum movements on a screen.

Image credit: Canva

How is it done?

Older children and adults sit in a chair, tilting their heads to the side to allow the healthcare provider to examine each ear. Your healthcare provider will likely hold your outer ear to stretch your ear canal so they can see your ear drum better.

If you take your young child for an ear examination, your healthcare provider will show you how to hold them. Often this will be sitting on your lap facing away from you. You hold one arm across their forehead and the other across both their arms. This keeps them safe while the otoscope is inside their ear canal. Young babies may have their ears examined snuggled against your neck, or on the bed.

The tip of the otoscope is gently placed into your ear and a light is shone into your ear canal and down to your eardrum. The otoscope is carefully moved to see the inside of your ear and your eardrum. The examination usually takes less than half a minute. 

An ear exam may be slightly uncomfortable or painful if you have an ear infection. Your healthcare provider will stop the exam and remove the otoscope if it gets worse.

The ear canal differs in size, shape, and colour from person to person. Normally, the ear canal is the colour of your skin and has small hairs. Yellowish-brown or white and flaky earwax may be present. If there's an ear infection in your ear canal your healthcare provider can see redness and swelling and may see pus.

Your eardrum is light grey or pearly white in colour. Light should reflect off the eardrum surface.

If light doesn't reflect off your eardrum it may be a sign of a middle ear infection or fluid. Your eardrum may be red and bulging if there's an infection. Orange-coloured liquid or bubbles behind your eardrum are often seen if fluid collects in your middle ear.

Not all ear problems can be detected by looking through an otoscope. Other ear and hearing tests may be needed. Read more about hearing tests in adults and hearing tests in babies.