Retina World Congress 2026: Sunir J. Garg, MD, FACS, on preventing occupational injury in retina practice

At the 2026 Retina World Congress, May 14–17 in Fort Lauderdale, Florida, discussions extended beyond surgical innovation and retinal disease management to include the physical demands placed on retina specialists themselves. Sunir J. Garg, MD, FACS, presented practical considerations for improving ergonomics in both clinic and operating room settings, emphasizing the cumulative musculoskeletal strain associated with daily ophthalmic practice.

Speaking from his experience with the Retina Service at Wills Eye Hospital in Philadelphia, Pennsylvania, Garg noted that although ophthalmologists benefit from advanced technology and surgical techniques, “all of that can take a toll on our neck and our back.”

Garg framed the issue within the realities of a growing and aging patient population, noting that many ophthalmologists are seeing higher patient volumes with increasingly repetitive physical demands. “Helping to prevent injury early can allow us to continue to have very healthy, productive careers for decades to come,” he said.

Clinic positioning and slit lamp challenges

Garg highlighted a recurring mismatch between ophthalmic workflows and ergonomic principles. He described common clinic setups in which computer monitors are positioned “90 degrees away from where the patient is,” forcing physicians into awkward twisting and leaning positions while simultaneously speaking with patients and documenting encounters. He characterized this as a “quasi-squat, lean over, turning my neck thing,” which places stress on both the neck and back.

He also highlighted limitations in slit lamp design and exam room configuration. Older patients often struggle to lean forward, leading physicians to compensate by hunching toward the patient. Garg noted that even exam room furniture can contribute to strain, describing oversized tables that unnecessarily increase the distance between physician and patient. “Then I have to lean forward and tilt my head back, all of which is ergonomically really stressful,” he explained.

Operating room setup and small ergonomic adjustments

In the operating room, Garg advocated for a surgeon-centered setup rather than adapting the surgeon to the existing bed and microscope position. “Put yourself in a position that’s comfortable,” he advised, recommending that surgeons first position their chair and pedals appropriately, then bring the patient and microscope into alignment. Maintaining an upright posture and positioning the oculars to allow a neutral neck position were recurring themes throughout the discussion.

Garg also addressed smaller repetitive stresses, including indirect ophthalmoscopy and handheld slit lamp lens positioning. He recommended supporting the arm with an elbow pad rather than “dangling your hand in front of the slit lamp,” which he noted is “really stressful on the neck and the back.”

Finally, Garg noted the need for ongoing collaboration with equipment manufacturers and ergonomic experts. Current devices are often designed by engineers who may test equipment briefly but “are not doing it 60 times a day every day.” He encouraged continued dialogue with industry partners to improve ophthalmic equipment design over the lifespan of products that may remain in use for “30 or 40 years.”