Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Seek emergency help for new facial drooping, difficulty closing one eye, confusion, severe dizziness with neurological symptoms, or weakness affecting an arm or leg.
These are not expected symptoms of an uncomplicated keratin plug and may indicate a serious complication or another condition.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Seek urgent, same-day medical assessment for:
Rapidly worsening or severe ear pain
Fever with ear discharge or increasing redness
Swelling or tenderness behind the ear
Bloody discharge without a clear minor cause
Sudden hearing loss, especially if the canal does not feel blocked
Severe pain in someone with diabetes or a weakened immune system
3
Does any of this apply?
Book an appointment
Arrange a routine appointment if you have persistent ear blockage, gradual hearing reduction, recurring plugs, or discomfort that does not settle.
These symptoms have many possible causes and do not confirm keratosis obturans.
The article also says
If you have already been diagnosed, contact your ear clinic when familiar symptoms return rather than waiting for a scheduled visit if the blockage is becoming painful.
Every sign above is quoted from the sofidex article on Keratosis obturans. If you are not sure, err upward — it is always reasonable to be checked.