How to Choose an Otoscope

Heine Otoscope & Opthalmoscope

With so many otoscopes to choose from, what’s the difference between a £25 model and one costing ten times as much, if not more? Does it matter what type of light bulb it uses? Should you get an otoscope that uses fibre optics?

To help you answer these questions, we’ve put together this short guide to help you think through selecting the otoscope that’s best suited to your needs and your budget.

Read right to the end, because our summary contains an often-overlooked factor that could make a massive difference to your choice.

Select the most convenient size

Otoscopes come in two different sizes – standard and pocket.

The smallest otoscopes are pen-sized, including a clip to hold them securely in your pocket. Lighter than the full-size models, their construction is normally not as robust, so they’ll probably have a shorter lifespan. Metal pocket clips will generally outlast plastic clips.

When choosing which size of otoscope is right for you, consider the environment where you’ll be using it and the types of patient you’re likely to encounter.

Also, think about what size otoscope would best suit the way that you’re made. The smallest instruments, while relatively light, can be tricky for someone with larger hands. Equally, the more robust standard models tend to be quite weighty and this might be a critical factor for you, particularly if you’re using an otoscope many times a day.

Otoscopes - there are lots to choose from
Otoscopes – there are lots to choose from

Choosing the functions you want

The standard head on an otoscope comprises a lamp and a magnifying lens (typically 2.5x or 3x magnification), allowing you to get a good look inside the ear.

This lens is often removable, allowing instruments, such as a Jobson Horne probe, to be inserted through the specula and into the ear canal. This can be useful for procedures such as removing a foreign body from inside the ear.

Most models permit pneumatic otoscopy, with a port for an insufflation bulb.

The macro viewer is a variant on the standard head, boosting magnification to 4.2x. Some models also allow adjustable focusing. These instruments can be particularly useful for medical professionals who are long-sighted.

Power for your otoscope

There are three different options for powering an otoscope – disposal batteries (typically AA size), rechargeable batteries and a permanent connection to a power source.

The pocket-sized models generally take one or two AA batteries, although some use other types of disposable battery. The batteries are housed within the instrument’s handle.

Otoscopes nearer the top of the range may give the option of rechargeable batteries. Some models come with multiple handles which house the batteries and allow one to be recharged while the other is in use.

Permanently wired otoscopes generally come with a bracket for wall-mounting, along with a transformer for the power supply.

The otoscope lamp

You have a choice when it comes to the light source of your otoscope – use a filament bulb (either halogen or xenon) or use an LED bulb.

Additionally, you’ll need to choose between a direct light source and an indirect, or fibre optic, option.

Otoscope-lamp
Light source comparison: fibre optic ring (left) vs direct (right) – both on lowest power without specula

When new, filament bulbs, particularly halogen, can give off a very strong, clear light that’s ideal for distinguishing detail inside the ear canal. Unfortunately, these bulbs do dim with use, their light can become inconsistent, and their lifespan is generally measured in tens of hours.

The quality of LEDs, which are becoming more common, is improving all the time. This is illustrated below, where a hand has been illuminated with a first generation LED bulb (right) and a high quality, second generation bulb from the HEINE HQ LED range (left).

High-CRI-LED-vs-1st-generation-LED-lamps-small
High CRI LED (left) vs a first generation LED (right)

The early LED light has removed almost all the colour from the hand, while the newer, high quality LED, reveals much more colour definition, which is important when assessing the health of an ear canal.

The bulbs used in some quality LED otoscopes, such as those from HEINE, are measured against the colour rendering index (CRI) to assess their accuracy in showing true colours.

Where LEDs really beat filament bulbs is with their lifespan, which can be thousands of hours. Many otoscope manufacturers guarantee their LED bulbs for several years. Because LEDs offer excellent brightness and consistency of light for lower power, they don’t dim so quickly and offer considerably longer battery life.

Some otoscopes include a rheostat function, allowing you to control the brightness of the light beam.

The benefits of fibre optics

Many otoscopes now use fibre optic filaments to direct the light from the filament or LED bulb. Typically, this allows light to be directed into the ear canal from a ring around the specula. This design ensures there is nothing to obstruct vision through the lens.

This is not the case in otoscopes with a direct light source, as the bulb needs to sit inside the specula to be directed into the ear canal.

Selecting reusable or disposable specula

Selecting between reusable and disposable specula is unlikely to influence your choice of otoscope, as most can be used with either. Generally they come in multiple sizes, to suit adult and paediatric use.

Specula can be disposable or reusable
Specula can be disposable or reusable

Unlike reusable specula, disposables don’t require complete decontamination after use because they are simply removed and binned. Some models of otoscope include a specula ejection system, meaning there’s no need to touch the contaminated item after use.

While specula are very similar, we recommend that you use the appropriate brand for the manufacturer of your otoscope.

What colour for your otoscope?

Of all the decisions you’ll need to make when selecting an otoscope, colour may seem the least important. After all, as a piece of medical equipment, how well it works is more important than how it looks.

That hasn’t prevented manufacturers from offering at least some models in a range of colours. And why not? Take the opportunity to express something of your personality or preferences!

In summary: choosing your otoscope

When selecting an otoscope you most definitely need to consider:

  • Size (pocket or standard)
  • Functions (rheostat, macro, removable lens, insufflation port)
  • Power source (battery, rechargeable, mains powered)

It’s also worth paying attention to:

  • Bulb type (filament or LED)
  • Light source (direct or indirect/fibre optic)

Other considerations:

  • Reusable or disposable specula
  • Colour

Last but not least you should factor in:

  • Purchase price
  • Lifetime cost of ownership

Understanding the real cost of your otoscope

Given that all otoscopes do the same basic task, why pay up to ten times more for a top of the range model?

Because the true cost of an otoscope is more than just the purchase price. You should factor in the price of replacing bulbs and replacing batteries.

The life-time cost of an otoscope is often overlooked at the point of purchase.

Diagnostic-SetWhile a mid-range LED otoscope may be twenty pounds more expensive than a filament bulb version, it probably comes with a guarantee that the LED will last for at least 2-3 years and possibly more. In that time you might replace a filament bulb several times, at a total cost much higher than the twenty pounds you saved at the point of purchase.

The least expensive, unbranded, otoscopes can appear to be a bargain, but getting replacement parts may be impossible.

As one of the UK’s leading suppliers of otoscopes, we purchase directly from the manufacturer and we stock, or can access, spares for all the models we supply.

Here’s a tip for saving money on buying an otoscope: take a look at the price of a diagnostic set that includes an ophthalmoscope. You may not be looking for an ophthalmoscope, but you may find that a full diagnostic set works out cheaper than buying just an otoscope.

And finally…

If you still have a question about choosing an otoscope, please ask us. You can reach us through live chat on our website, or Facebook or Twitter.

We offer free engraving on all the otoscopes we sell. Click here to see our full range of otoscopes, available today.