A Comparison of Examination Equipment Used During Common Clinical Ophthalmologic Tasks.

Abstract

Background: Ophthalmologists report a high prevalence of work-related musculoskeletal symptoms, particularly of the neck and shoulders. Improving the design of equipment used in the clinical environment may reduce exposures to physical risk factors (e.g., sustained muscular exertions and non-neutral postures) associated with neck and shoulder pain among ophthalmologists.

Purpose: To compare estimates of neck and shoulder muscle activity and upper arm posture during use of conventional and alternative examination equipment common in clinical ophthalmologic practice.

Methods: Fifteen ophthalmologists performed one mock clinical examination using conventional equipment and one mock clinical examination using alternative equipment with the potential to reduce exposure to sustained muscular exertions and non-neutral upper arm postures. The alternative equipment included a slit-lamp biomicroscope with inclined viewing oculars, adjustable elbow supports, and a wider table-top with more room for supporting the arms in comparison to the conventional slit-lamp biomicroscope. A wireless binocular indirect ophthalmoscope was also evaluated that had a more even weight distribution than the conventional design. Measurements of upper trapezius and anterior deltoid muscle activity, upper arm posture, and perceived usability were used to compare the conventional and alternative equipment.

Results: In comparison to the conventional slit lamp biomicroscope, the alternative slit lamp biomicroscope led to (i) 12% to 13% reductions in upper trapezius muscle activity levels, (ii) a 9% reduction in left anterior deltoid muscle activity levels, and (iii) a 15% reduction in the percentage of work time spent with the left upper arm elevated in positions greater than 60°. In addition, participants rated the comfort and adjustability of both the alternative slit lamp biomicroscope and binocular indirect ophthalmoscope more favorably than the conventional equipment.

Conclusions: The results suggest that the alternative slit-lamp biomicroscope may help to reduce overall muscular demands and non-neutral postures of the neck and shoulder region among ophthalmologists.