Earlier in my career, I viewed the slit-lamp exam as something we ophthalmologists simply did, without thinking too much about the details outside the eye. Over time, I started hearing colleagues complain about stiff necks, aching shoulders, and nagging wrist pain. These were not isolated stories—they were patterns that pushed me to take a closer look at how we physicians sit, lean, twist, and brace ourselves during what can easily be 100 exams per week.
PHYSICIAN POSITIONING
A few seconds of preparation before examining a patient can make a big difference. I adjust the chair so that my thighs are parallel to the floor and ensure that the joystick sits at elbow level for optimal upper body positioning.
PATIENT POSITIONING
Attention to patient positioning is crucial. Raising or lowering the chair, adding a small cushion for short patients, or adjusting the table to avoid contorting myself used to feel like extra steps during a busy clinic day. Now, I see these adjustments as an easy way to avoid the quiet accumulation of strain. With wheelchair users, I have learned to adapt the slit-lamp setup to them rather than force my body into an awkward angle I will pay for later.
LENS-BASED EXAMS
The same attention to ergonomics exercised for patient exams should be paid to lens-based exams. Whether I am using a 90D lens or a Goldmann lens, bracing myself properly—resting a hand on the patient’s cheek, keeping my elbows supported, and switching hands when possible—helps me stay more relaxed and stable.
MICROBREAKS
Microbreaks are magic. Pausing to do a quick shoulder roll, straighten the spine, and take a deep breath between patients can reset the body and keep fatigue from building.
SUMMARY
Ergonomics is not a luxury or an afterthought. It is a quiet but essential skill that protects us for the long haul and ultimately allows us to stay present and precise for every patient who sits behind the slit lamp.
