This is one of the most misused medicaments. On several occasions, ear drops are instilled by the Patients or Family members by themselves or on the advice of nearby Medical shop man.
It is a common belief that for every ear symptom, there should be application of an ear drop. I have noticed the disappointment on the face of the patient when I say "no ear drops" for an Eustachian Catarrah causing ear block. But, the fact is for majority of the ear symptoms, there is no indication for ear drop.
The treating (non ENT) physician should keep in mind that the ear canal is a cul-de-sac (blind alley) which is normally dry into which we are dumping a liquid. Whenever I happen to examine a patient with an ear symptom, if no ear drop is applied already, I can make a perfect spot diagnosis which can be messed up, if the patient comes after appling ear drops.
I don't undermine the utility of ear drops when applied at the right situation. Ear drops come in so many different compositions.
Plain antibiotic ear drops, with steroids, antifungal or all in one drops containing all the possible ingredients (This masala drop is misused by ENT Practitioners too.)
Wax solvent ear drops have thick oily appearance which form a nice mixture with wax and doesn't get absorbed by wax. If water based ear drop is applied on the ear with wax, it gets absorbed, and the blocking sensation and the pain become worse.
A big "NO EAR DROPS" for a suspected traumatic rupture of tympanic membrane. Hence, it is better not to apply any ear drop for a history of trauma to the ear.
If an insect is suspected to have entered the ear, liquid paraffin can be applied which doesn't cause any reaction.
Long term use of certain ear drops can promote granulation and cause irritation.
Carry Home Message:
Ear drops should be prescribed only by those who can look into the ear.
It is more important to treat with systemic antibiotics, anti-inflammatory, anti allergy medicines and nasal drops than using ear drops as the first aid.
Hence, ear drops come as the bottom-most medicine in my prescription.