Neck and shoulder muscle activity among ophthalmologists during routine clinical examinations

• Computer use was the most frequently performed clinical activity.
• Muscular effort was greatest during tasks requiring use of an indirect ophthalmoscope.
• Tasks requiring slit lamp biomicroscope use required the second greatest amount of muscular effort.
• Interventions should target tasks requiring use of an indirect ophthalmoscope and slit lamp biomicroscope.

Muscular demands during common clinical ophthalmologic activities may contribute to the high prevalence of musculoskeletal health outcomes observed among ophthalmologists and other eye care physicians. Characterizations of the muscle activation patterns in the live ophthalmologic environment are lacking. This study was conducted to (i) characterize the frequencies and durations of common activities performed by ophthalmologists during routine clinical examinations, (ii) characterize neck and shoulder muscle activation patterns during the whole clinical work day, and (iii) explore differences in neck and shoulder muscle activation patterns between common clinical activities. Fifteen ophthalmologists performed routine patient examinations in an outpatient ophthalmology clinic while continuous surface electromyography measurements of the upper trapezius and anterior deltoid muscles were obtained. Results indicated that while computer use was the most frequently performed clinical activity, use of the indirect ophthalmoscope, followed by use of the slit lamp biomicroscope, required greater muscular demands than computer use or other clinical activities. Results provide evidence that the clinical activities of indirect ophthalmoscope and slit lamp biomicroscope use are appropriate for ergonomic intervention.