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Up Front | Jul/Aug '24

Going Green in Ophthalmology: A Call to Action

As ophthalmic leaders, we bear a responsibility to champion sustainability and protect our planet. Some of our colleagues, particularly David F. Chang, MD, with EyeSustain and members of the AECOS Green Working Group (GWG), have embraced this challenge. Founded in 2022 under the leadership of Radhika Rampat, MBBS, BSc(Hons), David Shanazaryan, MD, FRCSI (Ophth), FEBO, and Neda Shamie, MD, the GWG aims to “ACT Locally, ImpACT Globally.” The goal is to have a sustainability warden in every eye unit worldwide, with many units already onboard. The GWG’s efforts include reducing plastic waste, encouraging recycling, and other projects. The organization also endorses EyeSustain and fosters collaboration with colleagues and industry partners.

The urgency of climate change demands decisive action. This issue of CRST Global | Europe Edition explores how ophthalmology can contribute to a greener future. Climate change affects us all. From wildfires to malnourishment, its impact on health is profound. We surgeons can play a vital role by minimizing our carbon footprint.

The health care sector, including ophthalmology, contributes significantly to carbon emissions. Surgical waste is the largest contributor; 20 cataract surgeries can generate enough waste to fill an OR. By adopting sustainable practices, such as using reusable instruments and minimizing single-use plastics, we can enhance patient care while reducing our environmental impact.

Embracing digital alternatives to printed Instructions for Use can save resources and reduce waste. Unfortunately, 70 countries still do not accept digital alternatives. By working closely with industry partners, we can develop ecofriendly solutions and promote responsible manufacturing practices. Education, policy development, and the establishment of targets for carbon emissions are essential steps toward sustainable health care.

Additionally, we face a sustainability challenge amid predicted workforce shortages in ophthalmology. Addressing this issue requires efficient system design. Streamlining referral pathways, creating peripheral imaging and treatment hubs, and optimizing patient flow can enhance sustainability. Collaborating with optometrists on the early detection and management of diseases can help alleviate the burden on ophthalmologists.

Machine learning algorithms can aid in diagnosing eye conditions, optimizing treatment plans, and predicting disease progression. By leveraging AI, we can enhance efficiency and reduce unnecessary interventions.

Teleophthalmology can bridge gaps in health care. Remote consultations, especially for follow-up visits and routine screenings, reduce travel-related emissions. We must, however, balance convenience with the need for in-person visits, especially for complex cases and collaborative research. Empowering optometrists to manage certain conditions independently can alleviate our workload.

Training programs should emphasize sustainable practices and interdisciplinary collaboration. Addressing the projected shortage of ophthalmologists by 2035 requires proactive planning. We must encourage medical students to pursue ophthalmology, support residency programs, and foster mentorship.

Sustainability in ophthalmology involves waste reduction, an embrace of technology, and collaboration across disciplines. By leading by example and working together, we can promote a greener, more resilient future for eye care and a healthier planet for generations to come.

Chief Medical Editor
Arthur B. Cummings, MBChB, FCS(SA), MMed(Ophth), FRCS(Edin), FWCRS
Physician CEO, Wellington Eye Clinic, and Consultant Ophthalmologist, Beacon Hospital, Dublin

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