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Every 10 seconds, a worker is temporarily or permanently disabled and some of them are physicians and surgeons. It is a well-known fact that medical professionals are prone to musculoskeletal disorders (MSDs), with ophthalmologists being particularly at a higher risk.[1,2] Common MSDs in ophthalmologists include disabling back pain, neck pain, numbness in the hands and legs, and carpal tunnel syndrome.[1,2] It may be hard to believe that most work-related disabilities in ophthalmologists are caused by simply doing the routine – performing a slit-lamp examination, using an indirect ophthalmoscope, or even sitting on a surgeon's chair. Although these injuries are chronic in evolution, the effects can be devastating.
Here are some hard facts:
It is evident that improper work ergonomics leads to disability, poor productivity, and early retirement.[11,12,13,14,15] The National Institute of Occupational Safety and Health has identified four factors influencing the development of MSDs: (1) environmental hazards, (2) human biologic factors, (3) behavioral factors or unhealthy lifestyles, and (4) inadequacies in existing health care. The problem being multifactorial, intervention to minimize the risk must have a layered approach.
Physical strains directly associated with the ophthalmic profession including stress on the shoulders, neck, back, arms, and hands resulting from poor posture during examination and surgery as well as repetitive actions common to the surgical profession are some of the modifiable risk factors. One of the eminently modifiable situations is ergonomic redesigning of our individual work places. Ergonomics is the process of designing or arranging workplaces, products, and systems so that they suit the professionals who use them. This is in sharp contrast to the typical hospital design that assumes that one size fits all.
The American Academy of Ophthalmology recognized the problem early and set up a task force to address the issue. The task force offers an online course encompassing the best practices in work place ergonomics.[12,13,14] Experts have recommended essential work ergonomics to help alleviate MSDs faced by the ophthalmologists [Table 1 and Figs. Figs.11 and and22].[13,14,15] Ergonomic intervention as detailed in Table 1, prophylactic neck and back exercises and timely professional consultation may help alleviate symptoms and maintain better work efficiency.[13,14] In a study of dentists undergoing an ergonomic makeover, a majority of them reported disappearance of their symptoms. In that same study, the mean working hours and work efficiency reportedly improved.
About 50 years ago, Laufman was duly concerned that “only a few surgeons have made the surgical environment their main research interest.”[17,18] The situation has not changed much. Our efforts to create an ergonomic clinic and operating room environment will require paradigm changes in the traditional concepts of design to have customization built into standardized hospital architecture. Instrument manufacturers should be provided with user-driven information to optimize ergonomics and provide adjustability. A greater involvement in this transformation by the ophthalmologists themselves may help accomplish the twin goals of personal well-being and increased efficiency while maintaining patient and staff safety.