The relationship between surgical loupes usage, workplace ergonomics, and musculoskeletal disorders among Saudi ophthalmologists

Saudi J Ophthalmol. 2024 Jul 3;39(2):166-173. doi: 10.4103/sjopt.sjopt_276_23. eCollection 2025 Apr-Jun.

Abstract

Purpose: To evaluate the knowledge, attitudes, and practices of surgical loupes among ophthalmologists and determine the relationship between this tool and musculoskeletal (MSK) disorders.

Methods: Between December 2020 and January 2021, ophthalmologists (trainees and consultants) working in Saudi Arabia received an anonymous, Internet-based survey through Google Forms.

Results: The total number of surveys completed was 93, and 82% reported pain with operating during the past 12 months; 87% reported neck pain, 81% reported shoulder pain, and 73% reported lower back pain. Sixty-eight percent chose to rest without seeking professional care. Forty-seven percent of participants exercise regularly. Sixty-nine percent attributed the pain to "bending or twisting your neck." Fifty-five percent of surgeons owned loupes, and only a third used loupes regularly. Forty percent indicated a limited field of vision as the main limitation. The Chi-squared test showed that MSK pain is a risk among all ophthalmic surgeons (P = 0.348). It was more prevalent among surgeons with longer experience. Increased surgical volume and prolonged operating time were associated with higher rates of pain. In addition, more frequent loupe use was associated with an increased prevalence of pain. The study found no statistically significant association. Finally, the activity level was significantly associated with a lower prevalence of pain (P = 0.028).

Conclusion: The majority of participants in this study experienced occupational MSK pain. Most participants owned loupes, and only a third used them regularly. Young ophthalmologists should be encouraged to apply ergonomic principles to safeguard against future MSK injuries.

Keywords: Ergonomics; loupes; ophthalmology.