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Otoscopic Eardrum Photos

Gallery of Otoscopic Views of the Eardrum

Viewing the eardrum with a home otoscope takes some practice, but soon you will be able to recognize subtle changes that may be medically significant, such as infection. These photos and more are available in the excellent Ears, An Owner's Manual.

Swollen Ear Canal from Swimmer’s Ear (Otitis Externa) Due to inflammation, the ear canal can be nearly swollen shut and have a discharge of pus. The first sign of swimmer’s ear may be pain or discomfort when you pull on the ear, or push on the tragus. You may notice a puslike discharge at the ear canal opening. Remember to look in the “good ear” first so you will avoid transmitting germs from one ear to the next. If there is pain when you touch the otoscope tip to the ear opening, DO NOT INSERT IT.

Foreign Body in the Ear Canal
Children sometimes insert small objects into their ear canals. These can range from small toys to objects of food. The foreign body at the right appears to be a small jewel. If you discover a foreign body in the ear canal, it is best to NOT attempt a removal. Food objects can expand or break into small pieces; sharp objects could scratch the sensitive ear canal or even pierce the eardrum. It is best to leave foreign body removals to your medical provider.

Soft Wax (Cerumen) Impaction in the Ear Canal
Earwax is a natural substance that protects the skin lining of the ear canal. Some individuals produce more wax than others, so wax impactions (blockages) can occur. Wax can come in many colors and consistencies, all equally unappealing to most people. If you discover a wax impaction during an otoscope exam, and the ear is NOT PAINFUL, you can wash out the ear with a gentle stream of warm water. Use your otoscope to check your progress.

Normal Right Eardrum
Eardrums can appear as different colors and still be considered normal. In this photograph, the eardrum appears whiter than the other previous normal eardrum photographs. The eardrum is translucent and has the normal cone of light reflection in the 5 o’clock position. The hammer (malleus) can be seen prominently from the 2 o’clock position to the center of the eardrum. The visible blood supply on the eardrum is not as evident on this picture.

Middle Ear Infection (Otitis Media)
As the infection progresses, the eardrum may take on a bizarre and unrecognizable appearance, since normal landmarks (cone of light, appearance of the hammer/ malleus) are missing. This photograph shows the characteristic bulging out of the eardrum due to pressure and/or fluid from behind. There is an obvious redness present due to the inflammation caused by the infection.

Severe Middle Ear Infection (Otitis Media)
This is an example of a severe ear infection, bulging to the point of a spontaneous rupture. It is likely that the person would be in much pain. The bulging of the eardrum has eliminated all normal landmarks and the inflammatory redness is profound. In most cases, even severe otitis media can be successfully treated with oral antibiotics and pain medications. An ENT specialist may decide to perform a myringotomy (a cut in the eardrum) to relieve pressure, drain pus, and reduce pain.


	middle ear fluid can be as thick as glue

Mucoid Middle Ear Infection
Not all middle ear infections are red and inflamed. Sometimes, a thick (see insert), yellow mucoid fluid will accumulate in the middle ear space. This can lead to a fullblown infection, or become more chronic and cause hearing loss.

Tubes in the Eardrum (Extruding)
This is an example of a plastic tube that is starting to extrude (being pushed out or rejected by the body). Most pressure ventilation tube insertions in children last from six months to a year, although there are permanenttypes of tubes that can be used.

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