I have yet to meet an ophthalmologist who does not care about a sustainable future for our planet, but the challenge lies in knowing where and how to start. Quite often, as individuals, we see ourselves less empowered when it comes to making environmentally suitable choices in our everyday practice, as discussed in the last issue of Eye News [1].
I would recommend EyeSustain (www.eyesustain.org) as a ‘go-to’ site for all updates and inspiration to making ophthalmology sustainable. EyeSustain was officially launched on Earth Day at the ASCRS 2022 annual meeting.
The initiative stemmed from a growing awareness among ophthalmologists about the environmental footprint of their practices. Surveys conducted by the ESCRS and North American societies (ASCRS, AAO, OOSS, COS) had revealed a strong desire among surgeons to reduce waste in the operating room. Recognising the fragmented nature of individual sustainability efforts and the lack of a central platform for information and collaboration, Dr David Chang spearheaded the idea of creating a dedicated resource, which then gained momentum with the support of key individuals and organisations.
EyeSustain has prioritised the development and promotion of practical, evidence-based solutions for ophthalmologists and their teams. This includes strategies for reducing waste in the operating room (e.g. re-evaluating surgical packs, minimising draping), minimising drug waste (e.g., promoting multi-dose use), and adopting greener practices in the clinic (e.g., reducing paper use, optimising energy). EyeSustain has published influential position papers on key issues, such as ‘Reducing Topical Drug Waste in Ophthalmic Surgery’, providing recommendations that have been adopted by accreditation organisations [2]. EyeSustain also participates in major ophthalmic conferences and events to raise awareness and educate the community through presentations, webinars, and discussions.
Today, EyeSustain has successfully built a significant global network, with over 40 international ophthalmology societies and organisations formally joining as member societies. A good starting point would be to read and take the EyeSustain pledge for your department and you can join the growing number of ophthalmology institutions across the globe who have done so, and feature on the EyeSustain Pledge Wall.
On a national level, our Royal College of Ophthalmologists (RCOphth) has established a Net Zero Working Group dedicated to driving changes across the eyecare landscape. This group focuses on raising awareness, producing guidance, promoting best practices, and evaluating the College's own environmental impact.
The College produces and disseminates guidance and actions for ophthalmologists on how best to decarbonise eyecare, and published a position paper on ‘Sustainability in Ophthalmology’, calling for leadership to develop and integrate best practices into service redesign [3].
They have contributed to the development of tools like the ‘Green Theatre Checklist’ in collaboration with surgical colleges in the UK and Ireland [4]. The RCOphth supports research comparing the carbon footprint of different clinical pathways and treatments to identify more sustainable options (e.g. comparing different anaesthesia techniques for cataract surgery). The College also collaborates with other organisations, including EyeSustain and the College of Optometrists, to promote a unified approach to sustainability in eyecare.
Our current Green Champion at North West Anglia NHS Foundation Trust, Nisha Nixon (ST5), with her TPD, Evangelos Minos, at a tree-planting event at our hospital.
Locally, we have designated our senior trainee in the rotation to act as a Green Champion for the department. Our youth have great vision for the future and are bursting with ideas which they are encouraged to implement. The post will pass onto the next trainee once the rotation ends, so that there is a constant review of our processes with each fresh pair of eyes. The trainees have an opportunity to demonstrate teamwork and leadership attributes and hopefully implement the experiences at the next trust in their rotation.
In the next issue, I shall be sharing some achievements made by eye departments in the UK in reducing their carbon footprint. I would encourage readers to share their successes, which would be useful to showcase here and inspire others.
References
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https://www.eyenews.uk.com/news/post/sustainability-in-ophthalmology-and-healthcare-an-overview
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https://www.eyesustain.org/events/reducing-topical-drug-waste
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https://curriculum.rcophth.ac.uk/wp-content/uploads/2014/11/2013_PROF_222_Sustainability-in-Ophthalmology-May-2013.pdf
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https://www.rcseng.ac.uk/-/media/images/rcs/about-rcs/sustainability/greentheatrecompendiumofevidence.pdf