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My sisters-in-law upcycle wool sweaters by making mittens out of the old fabric. They comb the thrift stores of Chicago for sweaters, wash and shrink the wool, design beautiful individual pairs, and sell them online and at craft shows. People love their mittens and embrace the idea of minimizing waste. But achieving sustainability feels overwhelming for many. That’s why a quote on their mitten Instagram feed resonates with me: “We don’t need a handful of people doing zero waste perfectly. We need millions of people doing it imperfectly.”
Cassandra Thiel, at NYU, studies health care sustainability and assesses the energy costs of surgical procedures. Cassie acknowledges the enormous task of achieving sustainability in health care, but she’s not discouraged. “While climate change looms large and making changes in the health care infrastructure is challenging, every ophthalmologist can do something to decrease the energy footprint in their workplace. This is empowering,” she said.
In the few years since EyeNet’s 2019 “The Greening of Ophthalmology” feature, our community has made huge strides in decreasing waste. For example, Eye Sustain, a coalition of several dozen ophthalmic organizations, launched in 2022. Sponsored by the Academy, ASCRS, and ESCRS, it has been working to decrease surgical waste and the carbon footprint of ophthalmic care. Jeff Pettey, at Moran Eye Center, leads the Academy Task Force on Sustainability and he cochaired a superb educational program on the topic at AAO 2023.
David Palmer, at Northwestern University, successfully drove a campaign to allow medications left over from surgery to be dispensed to the patient instead of the garbage. The 2021 Illinois law is changing policy in health systems.1 The Academy created a template from the bill designed by David and the Illinois State Medical Society,2 and now several state ophthalmology societies are introducing similar legislation.
Wiley Chambers, at the FDA’s Center for Drug Evaluation and Research, wrote an editorial in Ophthalmology in 2021 explaining that the 28-day expiration rule is not meant to apply to ophthalmic products,3 and many health care organizations are now amending their policies.
In 2023, the Academy partnered with the Moscone Center to decrease the carbon footprint of our annual meeting by reducing the use of single-use plastics.
EyeNet is doing its part, too. We often polybag our magazine with another publication such as EyeNet Selections: Retina. The plastic bag is convenient because ophthalmologists can see through the clear wrapping and identify it as EyeNet. But, while the plastic wrap is recyclable, it isn’t biodegradable. In an effort to be more sustainable, we are working with a printer whose values align with the Academy’s and we’ll now be bagging EyeNet in opaque white paper. So keep an eye out for our new, more planet-friendly look.
It’s often our young physicians who drive change. Barbara Erny, at Stanford University, is leading Stanford’s charge to update their curriculum to include education about the effects of climate change on global health and what we can do as physicians to address our contributions to climate change. She said, “Adapting our curriculum aligns with recommendations by the AMA and responds to the growing movement led by students and young doctors to incorporate climate change into medical education. The students are actually teaching their professors about the health impacts of climate change!”
As we lean into a new year, let’s celebrate the fact that creating leaner practices is becoming part of ophthalmic culture. And let’s keep the momentum going. Each organization can include sustainability practices as a core value—welcoming our employees’ and even our patients’ suggestions for small improvements. When sustainability becomes part of the DNA of an organization, decisions flow from that value.
When the enormity of climate change feels discouraging, I think of Cassie Thiel’s excitement about how, as a community, we can make a substantive impact. This is already happening, and it gives hope.
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1 aao.org/climate. Accessed Nov. 29, 2023.
2 aao.org/drop. Accessed Nov. 29, 2023.
3 Chambers WA. Ophthalmology. 2021;128(12):1667-1668.