Used to examine the ear canal and the eardrum, an otoscope is a hand-held instrument with a tiny light and a cone-shaped attachment called an ear speculum. An ear examination is a normal part of most physical examinations by a doctor or nurse. It is also done when an ear infection or other type of ear problem is suspected due to fever, ear pain, or hearing loss.

Some otoscopes blow a small puff of air at the eardrum to see if it will vibrate (a normal response). This type of ear examination with an otoscope can also detect a buildup of wax in the ear canal, or a rupture or puncture of the eardrum.

Prior to an otoscope exam, the patient will often be asked to tip his or her head slightly toward the shoulder so the ear to be examined is pointing up. The doctor or nurse may hold the ear lobe as the speculum is inserted into the ear, and may adjust the position of the otoscope to get a better view of the ear canal and eardrum. Both ears are usually examined, even if there seems to be a problem with just one ear.

The ear canal is normally skin-colored and covered with tiny hairs. A healthy eardrum is usually thin, shiny, and pearly-white to light gray in color. However, an ear infection will cause the eardrum to look red and swollen. In cases where the eardrum has ruptured, there may be fluid draining from the middle ear. A doctor may also see scarring, retraction of the eardrum, or bulging of the eardrum, indicating damage to this delicate structure.

If an ear infection is present, the patient may require treatment with antibiotics. If there is a buildup of wax in the ear canal, it might be rinsed or scraped out with special instruments. (It is normal for the ear canal to have some yellowish-brown wax, however.)