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The Ergonomics of Eye Surgery

Aug 16, 2022

You may serve over a hundred patients per week on month- they are all unique.  The things that remain constant for you are your surgery chair, your examination chair, your microscope, foot pedals, and surgery instruments.  


This article is to help you consider what improvements you can make now to prevent chronic and physical       problems such as neck pain, shoulder pain, and loss of neck and shoulder mobility over the course of your day, your life and your career.


In all ergonomics situations, I always ask the questions:

  1. Is this efficient and comfortable?
  2. How often do will this task be done?  For how long each time?  
  3. If this task were done a million times in the same way over twenty years, how would your body respond? 

The number one thing you need to know is:  From a physics point of view, if you are standing or sitting upright, the body is engineered to balance weight front to back, left to right, on the aggregate axis created by the natural curvatures of your vertebral column.  The neck is engineered such that the weight of your head is transferred through the natural weight–supporting surfaces of each vertebrae, down through the pelvis and chair, if you’re sitting; pelvis, legs and feet if you are standing.  All the functionality of this weight-bearing axis support system breaks down the moment you lean your head forward to view into the microscope.  

When you lean your head forward three things occur: 

First, the weight of your head is no longer easily supported by the columnar surfaces of your vertebral axis.  Second, the muscles of your upper back and neck must contract to keep the weight of your head upright, plus manage your precise head moments.  Third, the weight of your head, now forward of the body’s mid-lines acts as a compressive force which shortens the anterior surface of the body, compresses the rib cage and affects the breath and overall body comfort.

(“Houston”) We have a problem.

On a good day in an ideal and perfect world, looking down into microscope binoculars once or twice a day is not an issue.  However, an opthalmologist whose primary job involves leaning forward and looking down into a microscope – now that’s an issue.  The problem is not looking into the microscope.  The problem is leaning forward to look down a hundred times a week for at least several minutes at a time, fifty weeks per year.

Over the course of a career, this could mean your neck and shoulders are hunched over like a turtle (turkey?).  This could mean chronic neck and shoulder pain you may be destined to have forever.  It can mean accelerating the aging process, and more.

The number two thing you need to know is; as a dynamic organism, your body is not destined to have these problems if you are continually working to balance the physics of your work with the action of restoring and maintaining your flexibility, freedom of movement, and ultimately your body alignment.  This is very important – left unchecked, the very ailments you fear the most as a result of your work – will likely occur.  

The good news is that it is all preventable and reversible.  Rather than go into entirely of what can be done, I’d like to focus on just head-neck shoulders.  

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