The first step is for your GP to physically examine your ear. Using an instrument with a light at the end, called an auriscope or otoscope, they will look for anything that is not normal, including; discharge, a bulging ear drum, perforated ear drum or an object that might be blocking the ear.
You may also be asked about any pain or discomfort which you may be experiencing.
Tests include whispering or ticking watch, tuning fork, audiometry or bone oscillator:
Whispering or using a ticking watch. One ear at a time will be blocked and the nurse or doctor will test your hearing with sounds of varying volumes. In the whispering test, you might have to repeat the words out loud, when you hear them whispered.
Tuning fork. A tuning fork is a Y-shaped metallic object which, when tapped, produces sound waves at a fixed pitch. It’s usually used for tuning instruments. Doctors use a tuning fork by tapping it on their elbow or knee, to make it vibrate, then holding it at each side of your head. It will be held first in the air near your ear, to see how well you hear sounds that are transmitted through air vibrations. Then it may be held to the bone behind your ear (mastoid bone) to see how well you can hear when the waves are transmitted to your inner ear through the bone.
Audiometry. In this test you are given earphones to wear, which are attached to a machine. Sounds of different volumes (loudness) are played through the earphones, and you have to indicate whether you heard them. You might have to raise a hand or press a button. Children might have to move a coloured block.
Bone oscillator. A slightly different test can be used to test how well you hear sounds that are sent through the bone rather than the air. This uses an instrument called a bone oscillator placed against the bone behind your ear.