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  • Sustainability in Ophthalmology: Networking for Impact


    In recent times, conversations in ophthalmology have centered on sustainability. Stakeholders around the globe have been deliberating the issue extensively. As young ophthalmologists (YOs) and key stakeholders for that matter, we have a responsibility to steer ophthalmology in a greener direction.

    Ophthalmology’s Footprint

    Health care has an enormous contribution to global greenhouse emissions, and ophthalmology is no exception. The carbon footprint of cataract surgery is reported in the range of 6 to 181.9 kg of carbon dioxide for each procedure  — higher for phacoemulsification than small incision cataract surgery and varying across different regions. With increasing access to eye care and an aging global population, more cataract surgeries are being performed, further compounding the problem.

    Adverse Effect of Climate Change 

    The effects on eye health are not excluded. The risk of developing cataract, age-related macular degeneration (AMD), dry eye syndrome, allergic conjunctivitis, infectious keratitis and other vector-borne illnesses increases as a result of exposure to ultraviolet radiation, extreme heat, air pollutants and increased vector breeding due to climate change. Climate crises also have the potential to disrupt provision of eye care services.

    With a call to action for “2030 in Sight’’ and “Global Eye Targets 2030,” (PDF) we need to act to ensure that our practices do not counteract the progress we have made in attaining eye health for all.

    Why We Generate Waste

    We generate a lot of waste in ophthalmology largely because of our single-use practices. This is necessitated by the need to ensure patient safety by adhering to strict safety protocols to prevent cross-infection, particularly endophthalmitis, which can be devastating for both the patient and the ophthalmologist. The COVID-19 pandemic and other epidemics have further heightened the need to employ stringent safety protocols. However, our environmental resources are finite and need to be conserved.

    What YOs Can Do

    We must stand up for our world and future generations. We need to network, learn from one another and collaborate to achieve a greener impact. We are the bridges to attain sustainability globally. We need to challenge the status quo without compromising patient safety and quality of care.

    It is essential that we embrace, validate and accept emerging research from across the globe regarding the reuse and recycling of ophthalmic equipment and energy-efficient practices. We also need to harness technology to help reduce waste:

    • We can employ QR codes to store some of the information on the instruction leaflets of our IOLs to help reduce the use of paper and the size of the packaging. 
    • We can also partner with industry to recycle some of our waste as raw materials to feed other sectors like construction and engineering. For instance, we may be able to recycle the plastic casings of our IOLs into other plastic products.
    • Having a keen interest in glaucoma, I’ve wondered how much waste accumulates from the numerous bottles of anti-glaucoma medications of patients in one country alone, or the number of eye drop bottles that are discarded in one tertiary ophthalmic hospital per year. Perhaps, we can explore avenues to recycle these if we trashed them separately.

    Policy Change

    Having a passion and zeal to adopt eco-friendly practices is the first of many steps to achieving sustainability in ophthalmology. We have to strongly advocate for policy and legislative endorsement to affect the changes we desire.

    I’d like to acknowledge our seniors in ophthalmology, the giants on whose shoulders we stand, for spearheading efforts to attain sustainability in our practice. Our most important time lies ahead of us. Our future is impacted by our today. The time to act is now.

    Headshot of Edinam Hutton-Mensah, MBChB, MGCPS About the author: Edinam Hutton-Mensah, MBChB, MGCPS, is an early-career ophthalmologist at the Komfo Anokye Teaching Hospital in Ghana. Her interests are preventing blindness from glaucoma, rehabilitation in glaucoma and outreach cataract surgery. She has been involved in seven cataract surgical outreaches in Ghana over the past three years and is a member of the interim executive committee of Ghana’s Young Ophthalmologist Forum.

    Further Resources

    Be sure to attend these events at AAO 2023:

    • SYM43 | Part III: Future of the Profession
      2-3:15 p.m. Sunday, Nov. 5, Moscone South, Room 151-152
    • Sustainability
      With David Chang, MD; Marybeth Farazdaghi, MD; and Danson Muttuvelu, MD
      YO Empower Hour
      1-2 p.m. Sunday, Nov. 5, YO Lounge
      Attend the session to discuss sustainability in your practice.

    Read Up

    The Academy also has these resources to help you maintain a sustainable practice: