Survey of musculoskeletal disorders among US ophthalmologists

Abstract

Purpose-To characterize the prevalence of work-related musculoskeletal disorders (MSD), symptoms, and risk factors among ophthalmologists.Methods-An online survey was distributed to ophthalmologist members of the Maryland Society of Eye Physicians and Surgeons. The survey consisted of 34 questions on respondent demographics, practice characteristics, pain, and effects of MSD on their practice patterns. Participants were excluded if they were not ophthalmologists or if they had MSD symptoms prior to the start of their ophthalmology career. Demographics and practice patterns were compared for those with or without MSD symptoms using the Welch t test and the Fisher exact test.Results-The survey was completed by 127 of 250 active members (response rate, 51%). Of the 127, 85 (66%) reported experiencing work-related pain, with an average pain level of 4/10. With regard to mean age, height, weight, years in practice, number of patients seen weekly, and hours worked weekly, there was no difference between respondents reporting pain and those without. Those reporting MSD symptoms spent significantly more time in surgery than those who did not (mean of 7.9 vs 5.3 hours/week [P < 0.01]). Fourteen percent of respondents reported plans to retire early due to their symptoms.Conclusions-A majority of respondents experienced work-related MSD symptoms, which was associated with time spent in surgery. Modifications to the workplace environment focusing on ergonomics, particularly in the operating room, may benefit ophthalmologists.Recent literature has shed light on MSK pain in ophthalmologists and optometrists, whose work includes slitlamp examination and indirect ophthalmoscopy and, for many ophthalmologists, surgery, all of which may be risk factors for injury. Kitzmann et al 9 showed that optometrists and ophthalmologists have statistically higher prevalence of MSK pain compared to their family physician counterparts. An Australian study 10 followed 297 optometrists and found that 81.5% reported MSK pain in the previous 7 days. Venkatesh et al 11 conducted

Digital Survey Assessment of Factors Associated with Musculoskeletal Complaints Among US Ophthalmologists

“…As observed in prior surveys, over-the-counter medications were a popular option, while surgeries and opioid use was seldom required. 1 , 3 , 5 , 6 , 9 The high frequency of postural changes and stretching aligns with prior claims that “working in the same position for long periods” and “working in awkward or cramped positions” contribute to ophthalmologists’ pain. 8 Furthermore, respondents in our study with greater spine-related disability were more likely to pursue practice modifications or attempt treatments.…”

“…Nearly half of the sample (48.1%) reported daily or weekly pain episodes, a rate that is within the range of prior reports. 6 , 9 Despite the high frequency of symptoms, our study found that there may be an underdiagnosis of MSK diseases in ophthalmologists, especially for shoulder pathologies. Slightly over half (54.2%) of those reporting shoulder pain had a corresponding diagnosis, versus 64.8% with back pain and 71.4% with neck pain.…”

“…These values are comparable to the findings of Schechet et al 2021 in a sample containing multiple ophthalmology subspecialties. 9 A separate study of oculoplastic surgeons reported that 9.2% of its sample had ended their surgical careers due to pain, a notably higher amount. 10 It may be the case that loupe and headlamp use may cause greater musculoskeletal impairment than surgical microscopy.…”

“… 3–6 In contrast, Kitzmann et al 2012 found that number of patients seen per day was significantly associated with neck symptoms, and Schechet et al 2021 found that time spent in surgery was positively correlated with pain severity. 8 , 9 Ambivalent findings may be attributable to a variety of factors. It may be the case that some ophthalmologists feel increased pain while still maintaining a greater workload, while other ophthalmologists have already decreased their practice and surgery volumes prior to being surveyed due to pain, causing a net null calculation.…”

“… 1–10 Issues have been severe enough to cause some ophthalmologists to decrease their case load or cease conducting surgical procedures. 9 , 10 Pain has been reported in both the clinic and surgical settings, with many eye physicians believing that the use of tools like slit lamps, indirect ophthalmoscopes, surgical microscopes, and loupes contribute to their symptoms. 5 , 6 , 10 Microsurgery in general appears to affect MSK dysfunction, with suspected mechanisms including sustained forward head posture, muscular fatigue, and awkward positioning caused by equipment.…”