Ergonomics May Be the Key to Longevity for Ophthalmologists


Poor posture in surgical care has been long associated with worsened clinician health. It is no different in ophthalmology.

Tejus Pradeep, BA

Tejus Pradeep, BA

Ophthalmology, known for its well-balanced blend of microsurgical procedures and medical treatments, is widely regarded as an elegant medical specialty. This is evidenced by a competitive residency application process and a track record of physicians who are extremely satisfied with their profession.

According to a recent annual survey, ophthalmology is among the top 4 specialties where physicians report being happy while at work. However, perhaps just as contributory to satisfaction at work, is the career longevity and health of the practitioner.

Much has been made in the past 2 decades about poor postures and long-term health effects caused by microsurgical procedures. A 1994 study from the UK reported that more than 50% of ophthalmologists had significant attacks of back pain, with these numbers holding true in the US nearly a decade later.

A 2004 presentation from Uday Desai, MD, at that year’s American Society of Retina Specialists (ASRS) Annual Meeting highlighted that only 15% of vitreoretinal specialists reported having no symptoms of pain as a result of their profession. Another 55.4% of the 1130 surgeons surveyed reported both back and neck pain.

In the 15 years following this report, our conversations about improving ergonomics remains just as important. At this year’s ASRS meeting in Chicago, IL, last month, Jennifer Lim, MD, director of Retina Service at the University of Illinois (UI) Health Center, led an instructional course session about techniques to improve ergonomics and mindfulness during retina surgeries.

For our next generation of ophthalmologists, it is vital to train residents about proper postures and ergonomic techniques, to prevent health issues midway through a physician’s career.

Luckily, many promising efforts are already underway. The implementation of educational ergonomics modules for improving slit lamp positioning have shown promise in reducing unwanted shoulder flexion and elbow abduction, and promoting neutral body postures among residents. Furthermore, optical motion capture methods typically used by industrial manufacturers to electronically assess the ergonomic risks of products, are increasingly being applied to ophthalmic procedures such as strabismus surgery.

In 2008, TrueVision Systems launched the first 3D, ‘heads-up’ ophthalmic surgical system where users can avoid postural constraints of the surgical microscope. More recently, in 2016, the release of NGENUITY, has brought this technology to the field of digital vitreoretinal surgery.

Although the outcomes of these novel methods have yet to be analyzed, harnessing innovative approaches to improve the health of future ophthalmologists is part of the ongoing evolution of the field.

With diligent effort, we can ensure that ophthalmologists continue to experience long and fulfilling careers—because there is nothing worse than when your job becomes a pain in the neck.

Tejus Pradeep is a rising fourth-year medical student at Johns Hopkins University, School of Medicine in Baltimore, MD. In 2016, he graduated from Rutgers University with a Bachelor of Arts in cell biology and neuroscience, and a Bachelor of Arts in psychology. After graduating medical school, Tejus would like to pursue a career in the field of ophthalmology. The piece reflects his views, not necessarily those of the publication.Health care professionals and researchers interested in responding to this piece or similarly contributing to MD Magazine® can reach the editorial staff by submitting a request here.

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