title: Cervical occupational hazards in ophthalmic plastic surgery.
abstract: OBJECTIVE
  To increase awareness of cervical musculoskeletal disorders (cMSD) in ophthalmic plastic surgeons (OPS) and review strategies for management and prevention.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: aWest Virginia University Eye Institute, Department of Ophthalmology bDepartment of Human Performance and Physical Therapy cDepartment of Industrial and Management Systems Engineering, College of Engineering and Mineral Resources, West Virginia University, Morgantown, West Virginia, USA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Sivak-Callcott
authors.forename: Corrie A
authors.initials: CA
authors.lastname: Mancinelli
authors.forename: Ashish D
authors.initials: AD
authors.lastname: Nimbarte
mesh_terms: D006801:Humans; D009333:Neck / Q000601:surgery; D019838:Neck Injuries; D004856:Postural Balance; D011187:Posture; D012307:Risk Factors; D013518:Surgery, Plastic