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  • Extend Your Surgical Life by Protecting Your Neck and Back

    Surgeons and clinicians sacrifice themselves for their patients, said Deepinder Dhaliwal, MD, at Refractive Surgery Subspecialty Day. She said that ophthalmologists need to “fortify and strengthen ourselves so we can be vibrant for our whole lives.”

    Using herself as an example, she described and showed images of her scans and postures from when she was physically disabled by a repetitive stress injury, after which she made life changes in the areas of posture, nutrition, and exercise.

    The main message: “Think about ergonomics and posture every day.” Up to 50% of ophthalmologists have pain issues. To avoid musculoskeletal disorders, repetitive task diseases, potentially serious long-term injuries to the neck and spine, and possibly surgery, she said, pay attention to these issues:

    • Major issue: “The slit-lamp is a disaster,” said Dr. Dhaliwal. Keep a straight neck and use chairs and setups that will give you good posture. Do not crane your neck. To keep your neck straight, raise the patient’s chair so that you can roll your chair in closer, with the wheels under the patient’s footrest. You can also ask the patient to scoot toward you. Line up your eyes and the patient’s eyes at the same level.
    • Indirect issue: ‘text neck.’ “Texting at a 30-degree lean is like having a 40-pound weight on your head,” said Dr. Dhaliwal. This ultimately can cause alterations in the soft tissue.
    • Sit with good posture. Compared with lying down, standing puts 100 times the pressure on the spine and sitting puts 250 times the pressure. Get the right chair for you, such as a CO:RE surgical chair or saddle chair. On airplanes and in meetings, Dr. Dhaliwal uses a lumbar roll.
    • At the microscope, don’t raise shoulders or neck; keep shoulders and elbows down.

    The ideal posture involves strengthening the core and addressing the whole body. This means understanding ergonomic positions, being aware of posture with each activity, and stretching and strengthening the body.

    Her final tips? Meditation, which was helpful as part of her recovery without surgery, and, she said,  “do not ignore the pain!” Get help before more damage is done.

    —Kathleen E. Erickson

    Further reading: See “Ergonomics: Care for Yourself to Improve Patient Care” (August, EyeNet Magazine).

    Two-minute video: Watch Dr. Dhaliwal share some ergonomic pearls in this brief video, recorded before AAO 2022. 

    Financial disclosures: Dr. Dhaliwal: Allergan, Inc.: C; Glaukos: S; Haag-Streit Group: C; Johnson & Johnson: C; Kowa American Corporation: S; Lenz Therapeutics: C; Novartis: C,S; Noveome: S; Ocular Therapeutix: C,L; OysterPoint: C; Staar Surgical: C; TearSolutions: C; Trefoil: C.

    Disclosure key: C = Consultant/Advisor; E = Employee; EE = Employee, executive role; EO = Owner of company; I = Independent contractor; L = Lecture fees/Speakers bureau; P = Patents/Royalty; PS = Equity/Stock holder, private corporation; S = Grant support; SO = Stock options, public or private corporation; US = Equity/Stock holder, public corporation For definitions of each category, see

    Read more news about Subspecialty Day and AAO 2022.