ErgoPractice News – January 2018
As a result of ergonomic education, a majority of clinicians today are recognizing the importance of a neutral working posture to prevent work-related pain and injuries. Although loupes have been recommended as an ergonomic solution to help clinicians work with improved postures, many loupes still do not satisfy all ergonomic requirements. In fact, improperly designed and built loupes are the main cause for chronic neck pain and injuries. Since most loupes can help prevent lower back pain and injuries, loupe manufacturers are labeling their loupes ergonomic. But only truly ergonomic loupes, which satisfy MultiPoint Ergonomics™ requirements, can prevent pain and injuries in both the back and neck. How can we recognize truly ergonomic loupes?
In this month’s article, we will review two types of loupes which are called Ergonomic Loupes, and show a method to identify truly ergonomic loupes.
Loupe Ergonomic History
In the beginning, loupes were introduced to help clinicians see anatomical features better. Then it was recognized that using properly designed loupes can help users work with improved working posture.1
Before loupes became popular, most clinicians were forced to lean far over their patients to get a better view of their work (Figure 1a). To see any detail, they had to be as close to their subject as possible. This posture forms a C-shape in the spine as the clinician is forced to lean in from the waist and hover over their subject.2 Working in this contorted position has caused clinicians to have dangerous lower back, upper back/shoulder, and neck problems.
Earlier loupes designed to help see better-allowed clinicians sit more upright which greatly reduced lower back pain. However, these loupes actually created a serious new problem, as they would force the clinician to bend their neck steeply forward to accommodate the eye-line of the loupes (Figure 1b). These traditional loupes have become the main cause of chronic neck pain and injuries. These designs still persist today – they are called ergonomic loupes, but are really only half-way ergonomic loupes.
In 1993 SurgiTel introduced its first pair of truly ergonomic loupes, which can prevent both lower back and neck pain, continuing the development of various ergonomic loupe models (2.5x to 8.0x). With these truly ergonomic loupes clinicians can restore the natural S-curve to their spines, to sit and work comfortably all day (Figure 1c). Working in this fully balanced position, clinicians minimize stress, strain, and injury to the lower back, shoulder/upper back, and neck.
“Any Loupe is Ergonomic” Claims
Today “Ergonomics” has become a popular topic among clinicians – just about every loupe company has taken note and labeled their traditionally designed loupes as ergonomic. These are exactly the same designs as before, but re-labeled. For those who are looking to work safely and comfortably, how can they know if they are going to buy truly ergonomic loupes, or just the same type of product they had before?
Companies capitalizing on the current trend are correctly stating that their products are more ergonomic than not using loupes at all. Any loupes can reduce lower back pain and injury, as clinicians discovered nearly 50 years ago. This is not new information, not a new design, and not a real solution to the challenges clinicians face today.
Neck pain and injury is the modern issue with loupe ergonomics. Clinicians who are suffering still experience this issue from using non-ergonomic loupes which are labeled ergonomic.3 This serious issue is not being correctly addressed by loupe companies which simply label their traditional designs as ergonomic!
Truly Ergonomic Loupes: SurgiTel MultiPoint Ergonomics™ Designs
Truly ergonomic loupes have to satisfy multiple requirements. SurgiTel has begun to identify our truly ergonomic loupes as having MultiPoint Ergonomics™. MultiPoint Ergonomics™ designs should help prevent chronic pain and injuries in both lower back, upper back/shoulder, and neck. MultiPoint Ergonomics™ loupes allow clinicians to have proper working distance and to maintain a head tilt of fewer than 25 degrees.4
In the past, declination angles have been used to identify ergonomically correct loupes, but most manufacturers define the declination angle as the angle between the temple arm of frames and the loupe oculars. This will significantly increase the apparent declination angles of loupes if temple arms are attached to the top of the eyeglass rims. A true declination angle is the declining angle of eyes. It can be difficult to measure on your own, so the best way to identify truly ergonomic loupes is to measure the head tilt angle.
By measuring your head tilt angle wearing loupes you can identify true ergonomic loupes for your practice. The measurement of the exact head tilt angle can be found using two photos; one side view of neutral neck posture and another side view of working posture while wearing loupes.5 Figure 2 shows a method that finds an approximate head tilt angle with one side-view photo of a working posture with a pair of loupes.
Figure 2a shows excessive head tilt with traditionally designed loupes which can help lower back posture. However, the continued work with this excessive head tilt will create chronic neck pain and injuries. Traditionally designed loupes force the user to tilt their head and neck forward more than 25 degrees, which can lead to neck pain and eventual injury.4 The neck is an important area to protect, as muscle/nerve/spine damage can result in permanent injury or even end your career.6
Figure 2b shows minimum head tilt with SurgiTel MultiPoint Ergonomics™ loupes which help establish a working posture that protects both their back and their neck (Figure 2b). All SurgiTel loupes are designed to address every area of possible pain and injury by allowing the clinician to achieve the fully ergonomic S-curve to their spine. Non-ergonomic loupes can help with the lower part of the “S,” but fail at the upper part.
With customized working distances, clinicians are able to sit comfortably upright, protecting their back from strains and pains during a long workday. In addition to protecting the back, with personalized declination angles which are possible with patented designs of frames and optics, SurgiTel MultiPoint Ergonomics™ loupes are able to help clinicians maintain their head tilt within a safe range.
Many of our current customers purchased SurgiTel MultiPoint Ergonomics™ loupes because with their “traditional custom loupes,” which are re-labeled “ergonomic loupes,” they were still struggling with neck pain. With MultiPoint Ergonomics,™ clinicians are able to establish the proper posture and avoid working pain.
Get Your Posture Checked!
If you or someone you know is suffering from neck pain, despite using “ergonomic loupes,” please contact us. Our field team can help you determine your head and neck angle (this is the preferred way to measure loupe ergonomics: see our April 2017 issue). Note that working with an excessively tilted head will not create neck pain right away. It may take several years (3 to over 10 years).
To get your posture, or that of a colleague, checked, contact your local representative at www.SurgiTel.com/MyRep.
- Chang, BJ. “Ergonomic Benefits of Surgical Telescope Systems: Selection Guidelines.” CDA Journal, Vol. 30, No. 2, 2002.
- Highsmith JM, Vertebral Column: Backbone of the Spine. SpineUniverse, 2017. https://www.spineuniverse.com/anatomy.
- Hatchett, Darryl L., DDS. “SurgiTel Delivered the Magnification I Wanted Without Pain.” SurgiTel. February 2015. http://surgitel.com/news.
- Pulat, BM, Fundamentals of Industrial Ergonomics, Chapter 7: 177. Prospect Heights, Illinois: Waveland Press, Inc., 1992.
- Chang BJ. “Declination Angle: The Key Factor for Custom Loupes.” Oral Health, Vol. 4, No. 7, 2014.
- Humphrey, Dee, RDH, BHSc. “My 6-year Clinical Career from Non-Ergonomic Loupes.” SurgiTel. April 2017.