Wispr University

Visual Ear Diagnosis Guide

January 28, 2023

11032022 Acute Otitis Media Image unmounted

There are a number of ear conditions that are commonly found in clinic. This article presents six of the most common conditions seen in the primary clinic. Included are images of the condition, typical presenting history and annotated diagnostic features.

This guide is available here as a convenient pdf that can be downloaded and printed for learners or patients.


Wispr Otoscope Image, Description and Typical History

normal ear
Normal ear.

Healthy patient with no ear complaints and no history of ear infections or trauma.

Erythema (redness).

Crying child.


Myringosclerosis (sclerosis).

Patient with history of ear infections or ear tubes.

Otitis Media with Effusion (OME).

Several days of viral symptoms without significant ear pain. May have a sensation of ear pressure.

Acute Otitis Media (AOM).

Several days of viral symptoms followed by developing ear pain and decreased hearing.

Bullous Myringitis.

Several days of viral symptoms followed by significant ear pain and decreased hearing.

Annotated Image and Diagnostic Features

Annotated normal ear
Malleus is easily appreciated. Light reflex is present. No bulging of the ear drum.

Each ear is different and not all landmarks are visible in all ears.

annotated erythema
Common finding in a crying child that is not happy to be at clinic. Often confused with an infection if too brief a view is obtained.

annotated myringosclerosis
Myringoclerosis is calcium and phosphate depositions in the middle layer of the ear drum. Does not generally affect hearing. No treatment indicated.

annotated ome
No bulging. Air-Fluid levels indicate Eustachian tube is functioning properly. Antibiotics not indicated.


annotated AOM
Often described as an angry donut. Because of the bulging, no landmarks are visible. Easily appreciated as abnormal. Antibiotics should be considered.

annotated BM
Considered a severe case of AOM. Angry donut with blisters. Often quite painful. Antibiotics are generally indicated.