By Alma I. Murphy, MD
Surveys of ophthalmologists suggest a high prevalence of musculoskeletal disorders, but it is unclear whether this prevalence is comparable to other physician groups or which, if any, job factors may contribute to the symptoms. In this study, researchers used an electronic survey to compare the prevalence of musculoskeletal disorders among eye care physicians with that of family medicine physicians. Ophthalmologists and optometrists had a higher prevalence of neck, hand/wrist and lower-back pain. They cited repetitive tasks, prolonged or awkward/cramped positions and bending/twisting as the contributory factors.
Of 94 eye care providers and 92 family medicine physicians surveyed, the response rates were 99 percent and 80 percent, respectively. There were no significant differences between the two groups regarding mean age, gender, body mass index, years with current employer or years in practice. All participants were practicing at the University of Iowa or the Mayo Clinic.
Eye care providers reported a higher prevalence of neck pain (46 percent vs. 21 percent; P < 0.01), hand/wrist pain (17 percent vs. 7 percent; P = 0.03) and lower-back pain (26 percent vs. 9 percent; P < 0.01). A greater proportion of eye care physicians classified their job as high-strain (high demand, low control; 31 percent vs. 20 percent), and a lower proportion classified their job as active (high demand, high control; 24 percent vs. 47 percent; P = 0.01).
The prevalence of neck symptoms among eye care physicians in this study agrees with previous studies. However, the percentage of shoulder symptoms (11 percent) and low-back symptoms (26 percent) was somewhat lower. This may be due to the 30-day recall period or the use of a more restrictive definition of symptoms (i.e., self-reported symptom severity of greater than 3 on a 0 to 10 scale) rather than a yes/no response.
Recommendations and guidelines for improvements in the eye care ergonomic environment are lacking compared with other specialties. The authors found only three published articles that advise ophthalmologists on how to properly position themselves in the clinic and operating room. The ergonomic design of many of the instruments used by eye care physicians, such as the slit lamp, have changed very little since their invention. Given the findings of this study and others, the authors hope these data will encourage additional research, innovation and collaboration with industry in order to improve the work environment of ophthalmologists and optometrists.