Purpose <p>Work-related musculoskeletal disorders (WMSDs) are highly prevalent among healthcare professionals, including optometrists. This study aimed to assess the frequency, severity and contributing factors of WMSDs among Australian optometrists, as well as evaluate their awareness and implementation of ergonomic practices.</p> Methods <p>A cross-sectional online survey was distributed to optometrists in Victoria and South Australia. The survey collected data on demographics, work characteristics, ergonomic awareness, frequency and severity of musculoskeletal discomfort and contributing factors. Quantitative data were analysed using descriptive statistics and correlation analysis. Free-text responses were examined using inductive thematic analysis.</p> Results <p>Of 119 respondents, 84% reported neck discomfort, 71% shoulder discomfort and 73% lower back discomfort. Pain severity was highest in the neck and shoulders (mean ~6.5/10). Strong Pearson correlations were found between neck, shoulder and upper back discomfort. Repetitive tasks, static postures and awkward positioning were identified as primary contributors to discomfort. Slit lamp-based tasks were most frequently associated with exacerbating pain. Only 20% of respondents were aware of workplace health and safety policies and 97% had not received employer-led training on injury reduction. Thematic analysis revealed significant impacts on professional performance and personal wellbeing.</p> Conclusions <p>WMSDs are highly prevalent among Australian optometrists, particularly affecting the upper body. There is a lack of ergonomics education and workplace support. These findings highlight the need for improved ergonomics training in optometry education, implementation of workplace health and safety protocols and investment in ergonomic equipment. Future interventions should focus on addressing the identified risk factors and promoting a culture of safety in optometric practice.</p>