Is ophthalmology a pain-free career? A systematic review and meta-analysis of musculoskeletal pain among ophthalmologists

Objective To estimate the pooled prevalence, anatomical distribution, and occupational impact of work-related musculoskeletal (MSK) pain among ophthalmologists, and to identify modifiable ergonomic risk factors. Design A systematic review and meta-analysis of published data. The protocol was preregistered (PROSPERO CRD42023422368) and reported in accordance with PRISMA. Participants The participants were 6691 ophthalmologists from 21 studies. Methods Electronic databases (MEDLINE, Embase, Cochrane, and PubMed) were searched for peer-reviewed quantitative studies reporting MSK pain prevalence in ophthalmologists. Pooled estimates with 95% CI were calculated using random-effects models; heterogeneity was quantified using I ². Main Outcome Measures Prevalence of overall and site-specific MSK pain; effects on workload and productivity; prevalence of treatment or mitigation strategies. Results The pooled prevalence of any MSK pain was 70% (95% CI: 65%–75%; I ² = 92%); neck (41%; 95% CI: 35%–47%; I ² = 95%), lower back (36%; 95% CI: 32%–39%; I ² = 87%), and shoulder pain (28%; 95% CI: 22%–35%; I ² = 91%) were most common. Pain led to workload modification in up to 44% and contributed to reduced clinical volume, sick leave, or contemplation of early retirement. Forty-six percent (95% CI: 22%–71%) pursued no treatment; 39% (95% CI: 30%–49%) used medical therapy; and 29% (95% CI: 20%–41%) sought physiotherapy. Heterogeneity was high across studies, reflecting differing case definitions and self-reported measures. Conclusions MSK pain affects most ophthalmologists, particularly in the cervical and lumbar regions and frequently alters practice patterns. These findings underscore the need for early ergonomic training, structured micro-breaks, and workspace redesign. Prospective intervention trials are required to establish causality and quantify benefit. © 2026 The Authors.