Although the ear otoscope, a tool used to look in ears, has been used pretty much exclusively by doctors for almost 400 years, modern technology is now helping parents conduct ear exams themselves. Caring parents can now easily capture real-time images of their child’s ear to share with their physician for a diagnosis.

But not all ear-checking devices are the same. This article will explore the device doctors use to look into ears, what doctors look for during an ear-check exam, and why owning an otoscope can be beneficial.

What is an otoscope?

The beginning of ear-checking devices can be traced back to the 1300s when a renowned French physician and surgeon, Guy de Chauliac, envisioned a device to check ears by looking into the ears. This was the first known description of this medical tool that would one day be invented and used to check the ears of billions of people around the world.

But it wasn’t until about 300 years later in the mid-1600s and late 1700s that models were developed. These early otoscopes looked more like tongs, similar to nasal speculums.

The creation of the modern otoscope began in the middle of the 19th century when a German otologist named Wilhelm Kramer developed a steel speculum with a distinct funnel shape.

In 1881, A. Hartmann of Berlin created an otoscope with a style that resembles what we see today.

The modern otoscope, also called an auriscope, is a handheld diagnostic tool doctors use to look into the ears and ear canal. They may also use it to examine the nose and upper throat.

The instrument consists of a head and a handle. The head has a magnifying lens, a light source, and a speculum.

The light and magnifying lens enlarge and illuminate ear structures, allowing the clinician to visualize and evaluate the patient’s health accurately.

The speculum is a viewing piece shaped like a funnel with a narrow pointed tip. Specula come in different diameters to accommodate the size of the ear passage.

There are different kinds of otoscopes. A pneumatic otoscope comes with a rubber squeeze bulb that can be used to apply pressure to the eardrum to assess its movement. A video otoscope uses a small camera in the external auditory canal to visualize the ear drum.

Here is what the state-of-the-art Nonagon digital otoscope, which captures high-definition video of the inner ear to share with a clinician, looks like… 

What do doctors look for when using an otoscope?

Apart from the common cold, ear diseases or infections are the most common childhood illness and the most common reason parents bring their children to the doctor.^1,2 In fact, five out of six children will have an ear infection before they reach three years old.³

Children with ear infections often tug or pull at the ear or complain of ear pain.⁴ But the only way for a physician to confirm that someone has an ear infection is for them to see what’s inside the ear and, from here, interpret the symptoms and give a diagnosis.⁵

A doctor can use an otoscope to inspect the ear canal, eardrum, and middle ear to check for an ear infection (otitis media).⁵

They will see the following during an ear examination of a healthy eardrum:⁶

• eardrum appears pearly white or light grey
• the ear canal, lined with some yellowish-brown ear wax
• tiny bones visible in the middle ear
• slight movement of eardrums when air is applied

What does an ear infection look like through an otoscope?

In contrast, an ear with an infection (acute otitis media)  may appear red, swollen, or inflamed when there is an infection. It can also appear opaque, bulging, and immobile.⁵

Aside from this, an ear examination (otoscopy) can help doctors diagnose a wide variety of ear conditions,⁵ including:

• wax buildup (cerumen impaction)
• foreign objects in the ear
• otitis media with effusion (OME)
• otitis externa (OE)
• malignant otitis externa
• cholesteatoma
• tympanic membrane perforation

Checking the ears using an at-home otoscope