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Using an Automated Hirschberg Test App to Evaluate Ocular Alignment

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Evaluating Ergonomics Training in Ophthalmology Residency: A Pilot Study.

Matthew B Urban^1,2, Brandon M Bessen¹, Bentzion Kleiman¹

¹Ophthalmology, New York Medical College, Valhalla, USA.

|March 10, 2026

Summary

Ophthalmology residents who received ergonomics training showed improved posture during slit lamp examinations (SLEs). This suggests that incorporating such training into residency programs can enhance provider safety and reduce injury risk.

Keywords:

career longevity ergonomics graduate medical education ophthalmology residency ophthalmology training resident education

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Area of Science:

Ophthalmology
Medical Education
Occupational Health

Background:

Slit lamp examinations (SLEs) demand sustained focus and precise positioning, leading to potential poor posture among residents without formal ergonomics training.
Early development of poor posture habits can negatively impact resident well-being and healthcare system safety.
Targeted interventions during residency can promote safer examination techniques and reduce provider injury risk.

Purpose of the Study:

To evaluate the short-term impact of a structured ergonomics education protocol on the posture of ophthalmology residents during SLEs.
To assess the feasibility and effectiveness of integrating ergonomics training into ophthalmology residency curricula.

Main Methods:

A single-center pilot quality improvement study involving seven ophthalmology residents.
Baseline posture assessment using the Rapid Entire Body Assessment (REBA) scale, with higher scores indicating greater musculoskeletal risk.
Random assignment to an intervention group (n=4) receiving ergonomics training or a control group (n=3) receiving no additional training.

Main Results:

Mean REBA scores significantly decreased in the intervention group (p < 0.0001) after completing the ergonomics training.
No significant change in REBA scores was observed in the control group (p = 0.4).
The intervention group showed improved posture during SLEs, indicating reduced musculoskeletal risk.

Conclusions:

A structured ergonomics education intervention was associated with improved resident posture during SLEs.
The findings support the value of incorporating low-cost ergonomics training into ophthalmology residency programs.
This intervention may be transferable to other procedural specialties to promote occupational health and sustainable practice habits.