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    Neck pain in the exam room and how to alleviate it


    2. Slit lamp exam

    During slit lamp examinations, it is easy to adjust the height of the slit lamp to the patient. This creates unneeded stress on the OD’s neck, which may cause hyperextension. Fundus examinations at the slit lamp may also be taxing on the neck muscles as ODs manipulate the lens for good focus while adjusting the position of the slit lamp illumination.


    • Position yourself first, then move the patient to you. Be sure to keep your neck from hyperextending by pulling your chin to your chest as you set up the exam.

    3. Binocular indirect ophthalmoscopy (BIO)

    Depending on how you perform a peripheral retinal exam, the exam can cause work-related injury especially if it is performed with the patient in a seated position. When performing this procedure, the OD is working with her hands above her head to achieve good peripheral retinal views. This exam may also require stooping and stretching.

    Related: Process key to pain management


    • Patient positioning. It is best to lie the patient back and have the patient move his head to allow for better peripheral views.

    Combating tech neck

    In our personal time, many of us are guilty of using digital devices such as smart phones, Fitbits, and Apple watches. Tech neck is the act of holding your head flexed and forward while looking down at your device. Tech neck puts your cervical spine in a tenuous position.


    • Set time limits on a task: Take breaks for about three minutes for every 20 minutes you are using a device. During this time change your posture and move around.

    • Reposition: If you are too busy to know when repositioning is needed, set a reminder.

    • Eye level: When using a digital device or phone, keep it at eye level to minimize neck flexing and forward positioning.

    Aerobic exercise to alleviate pain

    Cardio exercise may increase blood flow to the muscles of the neck and upper back to help loosen muscles and increase range of motion. It is recommended to have 30 minutes of cardio exercise daily. Cardio releases mood enhancing endorphins that further improve neck pain.


    1.  Al-Marwani Al-Juhani M, Khandekar R, Al-Harby M, Al-Hassan A, Edward DP. Neck and upper back pain among eye care professionals. Occup Med (Lond). 2015 Dec;65(9):753-7.

    2. Long J, Naduvilath TJ, Hao LE, Li A, Ng W, Yip W, Stapleton F. Risk factors for physical discomfort in Australian optometrists. Optom Vis Sci. 2011 Feb;88(2):317-26.

    Read more from Dr. O'Dell here

    Leslie E O’Dell, OD, FAAO
    Leslie E. O’Dell, OD, FAAO, is the director of Dry Eye Center of PA and Wheatlyn Eye Care in Manchester, PA. Dr. O’Dell lectures ...

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    • [email protected]
      It is generally accepted that about 60% of patients suffer from some form of digital vision syndrome. Often digital vision syndrome manifests as neck pain, which is generally trigeminal nerve related. Neurolenses, a new product with variable horizontal prism in the vertical plane (see Neurolenses.com) eliminate or very significantly eliminate this pain in over 50% of patients. Perhaps the amount of near vision work that is part and parcel of what optometrists do day by day is, for some, a manifestation of digital vision syndrome. Anyone who has a binocular convergence disparity at near distances (more than 50% of people) are candidates for Neurolenses. This new, patented product is currently in only 25 USA practices, most in Southern California, and a few in South Dakota. Significant expansion will take place starting early 2018. I strongly suggest that optometrists follow the development of this product. This product is, I predict, going to be the biggest practice builder is many years.

    Optometry Times A/V