Evaluating Visual Discomfort Among Robotic Urologic Surgeons: Insights from A Survey on Eye Strain and Accommodative Lag

Abstract

Introduction:

Despite ergonomic advancements in robotic technology, physical symptoms and discomfort remain significant concerns for urologists, with symptoms increasing with years of practice. Eye symptoms, including accommodation lag, dry eyes, and eye strain, have been reported. This study aims to detail the visual challenges faced by robotic urologists and to further examine what factors could be contributing to these symptoms.

Methods:

A 22-item standardized survey developed with the recommendations from the Endourological Society Data Committee was distributed between October 2024 and April 2025. A total of 84 responses were received. Patients who performed no monthly robotic cases (n = 9) and those missing ≥ 5 questions (n = 1) were excluded. The survey addressed demographics, practice patterns, console time, and eye symptoms such as strain, pain, or watering. It also explored symptom timing, impact on postconsole activities, and preventive measures like breaks or eye drops.

Results:

The final analysis included data from 74 participants. Overall, 86% of respondents were older than 35 years. Most urologists (81%) had been practicing for more than 5 years, with 84% performing ≥ 3 robotic surgeries monthly. Console times were estimated to be 60–120 minutes for 43% of participants and > 120 minutes for 52%. About 73% used corrective eyeglasses, and 42% reported eye symptoms such as strain, pain, or watering while on the surgical console, which mostly occurred after more than an hour into surgical procedure (90%). Postoperation, 35% experienced headaches and eye fatigue, 30% had difficulties adjusting focus when transitioning from console work to paper/computer work, and 47% reported dry eyes. Over time, 33% observed a progression in symptoms.

Conclusion:

This survey highlights the prevalence of eye and vision problems among robotic urologists, underscoring the need for better ergonomic design, effective lighting, and preventive measures.