Ergonomics, Independence and Inclusion Take Center Stage | AAO 2025

If the future of retina specialty is to be bright, providers must care for their bodies, advocate for their businesses and create a more inclusive culture, according to this morning’s session at the American Academy of Ophthalmology (AAO) session, called ‘Public Health, Education and the Business of Retina.’

Christina Y. Weng, M.D., MBA, ophthalmology professor at the Baylor College of Medicine, began the session by speaking about the prevalence of occupational ergonomic injuries within the retina specialty world. She cited an AAO survey that found over half of ophthalmologists report neck, lower back or upper body pain associated with their job. That proportion increased to 85% when retina specialists were included.

Injuries may be attributed to high patient volumes, bending over patients for examinations and surgery. Even repeated micromovements done on the operating room, such as peeling membranes or using an endovenous laser, can be taxing on muscles, tendons and ligaments, Weng explained.

Weng broke down her advice by setting, beginning with the operating room. She emphasized that that patient’s body should be adjusted to the specialist. For example, keeping the patient’s head close to the top of the bed with the iris parallel to the ground.

In the clinic setting, Weng mentioned the neck strain from the diopter lens used while performing an ophthalmoscopy, especially for heavier lenses such as a 90 or 78 diopter lens.

“One of the worst things I think we put our bodies through as retina specialists is wearing a super heavy device on our heads and contorting our necks and bodies in strange ways,” Weng said. “Make sure the patient's chair height is high enough so that you're not bending over and then consider investing in a lighter weight device.”

Paul Hahn, M.D., Ph.D., former partner at New Jersey Retina/PRISM, talked about the changing landscape of healthcare and the importance of independent practice.

Hahn left a corporate practice a few months ago to start his own independent private practice. He called the change “refreshing” and credits that to his return to “patient-centric care.”

He said that while the profit of selling a practice is tempting, it comes at a cost, specifically at the expense of future earnings, because practice income goes down, with physician work reimbursement going into Wall Street. This leads to a market rate reset and salaries that may make the field less attractive to physicians, thus impacting patients.

“Every independent private practice carefully cultivates a practice culture of which it's proud, but every corporation struggles with what is aptly referred to as corporate culture,” he said.

Julia Haller, M.D., ophthalmologist-in-chief at Wills Eye Hospital in Philadelphia, finished the session by discussing how to build the future of the retina workforce

The demand for ophthalmologists will increase as the population ages. However, current workforce growth is inadequate to meet the projected needs over the next decade. This is especially true as new discoveries and surgical procedures require providers to expand their skillset, Haller explained.

Haller discussed the importance of collaboration and diversity as the key to preparing for the future.

“We will need to widen the table so it has room for more stakeholders, not just our physician and vision scientist colleagues,” Haller said. “We also need to include our nurses, techs and our colleagues. It means ensuring chairs at this table are not limited in terms of diversity and gender, race, background or geography. Creating an inclusive culture isn't automatic; it's done by design.”