In this surgical case, a resident surgeon takes on the challenge of a dense nuclear sclerotic cataract using a phaco chop technique. It is impressive to see such a high level of surgical proficiency so early in the learning curve; the mechanical spirit of the chop and the division of the dense nucleus are executed with good skill. However, there is a critical lesson here regarding microscope ergonomics and ocular stability. Throughout the procedure, the surgeon struggles to keep the eye centered in the primary position. Allowing the globe to drift or tilt significantly can compromise your view and increase the risk of complications. We discuss the importance of using the non-dominant hand and the phaco probe to maintain a neutral position. For any developing surgeon, mastering centration is just as vital as the chop itself to ensure a high margin of safety and a good surgical view.
