Bifocal and Multifocal Spectacles in Spine and Orthopaedic Surgery

Abstract

Presbyopia is common among experienced surgeons and may influence operative posture because bifocal and progressive-addition lenses require the wearer to align the visual target with a restricted near-vision zone. This issue may be particularly relevant to spine and orthopaedic surgery, where surgeons often maintain constrained head and trunk positions while viewing a deep operative field, fluoroscopic monitors, navigation displays, or instruments at different working distances. A focused review of PubMed-indexed literature identified evidence that bifocal and multifocal spectacles alter cervical posture in non-surgical tasks, a surgeon-specific review describing the ergonomic impact of presbyopia, and a small surgical study showing that prismatic spectacles can reduce neck flexion and discomfort. No direct comparative study was identified in spine or orthopaedic surgeons during live surgery. The available evidence supports task-specific optical assessment rather than assuming that everyday bifocal or progressive spectacles are optimal in the operating room. Prospective crossover studies should compare conventional multifocal lenses with task-specific single-vision, occupational, loupe-mounted, and prismatic systems using objective posture, muscle-load, visual-performance, and procedural outcomes.