Cervical occupational hazards in ophthalmic plastic surgery

PURPOSE OF REVIEW: To increase awareness of cervical musculoskeletal disorders (cMSD) in ophthalmic plastic surgeons (OPS) and review strategies for management and prevention. RECENT FINDINGS: There are objective data that show OPS spend the majority of their time operating in awkward, prolonged, static, asymmetric postures. These postures increase cervical load and cMSD. Loupes and headlamps further increase this cervical loading by 40%. Risk for cMSD is not limited to the operating room. Muscular demands in the anterior deltoid and cervical trapezius are increased in slit lamp biomicroscopy and indirect ophthalmoscopy. Furthermore, the majority of the office visit is spent keyboarding into the electronic medical record which is associated with cMSD. Habitual postural faults result from these cumulative exposures. These must be addressed to prevent further insult and debilitating injury. Successful management requires education in neutral posture, therapeutic exercise, environmental adjustments in the workplace and home, and supported neutral sleep posture. SUMMARY: The risks of cMSD in OPS are well established, and nearly 10% of cervical injury will end a career. Neck pain must not be ignored, and experienced professional help is critical. A long-term approach that incorporates exercise, manual therapy, and education is essential for management and prevention.