[Musculoskeletal problems in ophthalmology, risk factors and solutions: Case studies from two French practices]

According to international epidemiological literature, the prevalence of musculoskeletal disorders (MSDs) in the upper limbs and spine is a widespread phenomenon among ophthalmologists. However, few clinical case studies explore their actual work. The goal of this paper is to showcase and discuss the activity of ophthalmologists during office visits and surgery, to better understand the elements of their work that lead to MSDs, as well as protective factors and means of mitigation. The data collection methodology was based on observations of visits in two private practices (8d) and at a hospital (0.5d), observations in operating rooms (3×0.5d), individual interviews (4 ophthalmologists; 4 technicians; 1 nurse; 3 medical secretaries), and analysis of internal documents (human resources data, consultation or surgery schedules). The risk factors for MSDs among doctors stem, on one hand, from a mismatch between equipment and the actual constraints of their activity (ergonomic design and spatial layout), and on the other hand, from individual organizational factors (scheduling of patient types received during the day or week) and collective factors (task distribution and coordination between medical secretaries, technicians, and doctors). Preventive actions are possible at the individual level (equipment used, workspace design, professional motions, schedule design) and at the collective level (with other members of the practice, with the professional branch). Preventative actions can be implemented either by correcting existing situations or within the framework of a project for change.