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The price of chronic discomfort


By Helen Carter



Takagi inclined eye piece adaptor for slitlamps

Fiso chairs

Visionix autophoropters

Nidek RT 5100

Rodenstock Phoromat 2000 ­automated phoropter head

Swopper stools

Haag-Streit BQ 900 slitlamp


When optometrists are injured or suffer discomfort at work, they often look for ergonomic equipment to reduce further injury or pain. Robert Sparkes, managing director of OptiMed, says he hopes that soon it will routinely happen the other way around. ‘Practitioners should be proactive about preventing discomfort and injury, rather than waiting until it has occurred,’ Sparkes said.

Manufacturers are increasingly responding to the demand for functional design by producing an array of ergonomic ophthalmic instruments and equipment. While many optometrists are discovering the benefits of comfort-design equipment, far too many are still living with the pain. As a 2011 study has shown, over 80 per cent of optometrists report some form of work-related discomfort.1

Robert Sparkes says his company offers a range of products to aid in reducing injury risk, but they will go unnoticed by clients who are fixated on price alone. ‘When buying an optometry chair and stand, most practice staff just ask for a quote and the best price,’ he said. ‘We try to talk to the optometrists to ask if they have any neck injury or discomfort, but we rarely get that opportunity.’

If they did, the company could offer products to address those problems, he said. ‘The Takagi inclined eye piece adaptor for slitlamps, for example, helps solve neck problems.’

The value of adaptors like these, which are not very expensive, can be appreciated by the eye-care professionals who daily attempt to make their bodies conform to the demands of the machines, furniture and instruments in their consulting rooms.

The Fiso range of chairs and stands can be elevated or lowered depending on the height of the optometrist and patient. ‘Adjusting the height of the table and chair electronically enables the optometrist to conduct examinations in a more natural position,’ Sparkes said.

To help reduce the risk of repetitive strain injury in the fingers, OptiMed sells Visionix autophoropters, which are operated from an ergonomic keyboard on a wireless tablet.

E007 Figure 2.tablet controlled phoropter-F.jpg
Visionix tablet controlled phoropter (OptiMed)

Ergonomically-designed practice

NSW optometrist Janine Hobson is one of the very few who has designed her practice ergonomically to prevent injury. Her veterinarian husband Simon had injured his back at work and had to reduce his work capacity.

Consulting rooms, the dispensing area and reception areas are all computerised and networked. ‘All my equipment can be operated standing or seated and as the equipment is easy to operate, I change my position during the day. This ability to change positions has made consulting easier and more comfortable,’ she said.

‘Patients are seated in my consulting room with the chair and stand beside my desk. My desk height is higher than usual and almost bench height, so the patient is sitting level with me when behind the refractor head.

‘My chair and stand can be rotated and reclined and I use this feature for binocular indirect ophthalmoscopy. I perform a slitlamp examination seated in front of the patient. I use a direct ophthalmoscope but aim to have the patient at the equivalent of bench height with little bending.

‘Refraction is performed on our Nidek RT 5100 automated refractor head, which is easy to operate. There is no twisting and bending as the equipment is operated with a control panel and all information is cabled to the desktop computer electronically.’

Cameron Loveless from Designs For Vision Australia says automated phoropter systems like the Rodenstock Phoromat 2000 automated phoropter head are a major ergonomic advance for optometrists. They are operated with a control box like a keypad on a desk, instead of the practitioner manually moving older versions.

Device Technologies’ ophthalmic business manager, Mark Altman, agrees. He says his company has also sold many automated phoropter heads in the past 18 months because they are efficient and help stop back and shoulder strain. ‘These devices save practitioners from getting into the ergonomically terrible positions that they commonly do with the standard refractor head,’ he said.

Altman says that the thoughtful selection of the tools we employ in our daily routine can have a huge impact on our comfort and well-being. ‘Our Swopper stools from Germany are designed for physicians to strengthen the core and prevent stooping, allowing the practitioner to sit during the consultation, then move to the patient—instead of stooping forward—which helps the back stay more upright. Similarly, our Haag-Streit BQ 900 slitlamp features an angled eyepiece to reduce neck and back strain and allow a more natural head angle.

A shift in thinking is occurring among equipment manufacturers and distributors as they develop instruments that can alleviate many of the daily discomforts that optometrists commonly endure. It’s becoming increasingly important for optometrists, too, to be aware of their posture and comfort while at work. Enacting small, incremental changes to the tools you use in your work day may take a little time and cost a little money, but it may spare you grief and pain, and save you from early retirement.


E007 Figure 3. Ergonomics Nidek RT-5100-F
RT 5100 motorised Nidek automated refractor head (BOC Instruments)

1.      Long J, Naduvilath TJ, Hao LE et al. Risk factors for physical discomfort in Australian optometrists. Optom Vis Sci 2011; 88: 2: 317-326.

2.      Long J, Burgess-Limerick R, Stapleton F. Personal consequences of work-related physical discomfort: an exploratory study. Clin Exp Optom 2014; 97: 30-35.

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