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Lee GG, Menean M, Williams BK, Di Nicola M. Eco-sustainability in ophthalmology. Curr Opin Ophthalmol 2024; 35:403-408. [PMID: 38923880 DOI: 10.1097/icu.0000000000001070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
PURPOSE OF REVIEW The purpose of this review is to evaluate the current state of eco-sustainability in ophthalmology, highlighting key practices, recent advancements, and areas requiring improvement. This review aims to provide ophthalmologists with a comprehensive overview of sustainable practices that can reduce environmental impact. RECENT FINDINGS Recent studies have identified several areas within ophthalmology where sustainable practices can be implemented including multidose eyedrops, adjusting surgical packs, making package inserts available electronically, and reusing surgical instruments. Moreover, there is an increasing emphasis on waste reduction both in the surgical and clinical setting, by decreasing the use of unnecessary materials and implementing more efficient use of recycling programs. Telemedicine has also emerged as a sustainable option, reducing the carbon footprint associated with patient travel. Despite these advancements, significant challenges remain, particularly in balancing the cost and accessibility of sustainable options with traditional practices. SUMMARY Eco-sustainability in ophthalmology is gaining momentum as the medical community aims to reduce its environmental impact. While progress has been made, further efforts are required to overcome financial and logistical barriers to widespread implementation. Continued research, education, and policy development are essential to advancing eco-sustainable practices, ensuring that environmental considerations become an integral part of ophthalmic care.
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Affiliation(s)
- Gabriela G Lee
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
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Lam L, Bradbrook D, Gale J. Tracing the barriers to decarbonising ophthalmology: A review. Clin Exp Ophthalmol 2024; 52:78-90. [PMID: 38213078 DOI: 10.1111/ceo.14349] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/02/2023] [Accepted: 12/15/2023] [Indexed: 01/13/2024]
Abstract
As climate change demands increasingly urgent mitigation of greenhouse gas emissions, the health sector needs to do its part to decarbonise. Ophthalmologists share concerns about climate change and seek opportunities to reduce their environmental impact. When measuring the footprint of ophthalmology, major contributions are from patient travel to clinics, and from the large amounts of single-use disposable materials that are consumed during surgeries and sterile procedures. Ophthalmic services in India have already demonstrated systems that consume far fewer of these products through efficient throughput of patients and the safe reuse of many items, while maintaining equivalent safety and quality outcomes. Choosing these low-cost low-emission options would seem obvious, but many ophthalmologists experience barriers that prevent them operating as Indian surgeons do. Understanding these barriers to change is a crucial step in the decarbonisation of ophthalmology and the health sector more broadly.
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Affiliation(s)
- Lydia Lam
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Darren Bradbrook
- Surgery and Perioperative Medicine Division, Flinders Medical Centre, Bedford Park, South Australia, Australia
- Southern Adelaide Local Health Network (SALHN), Bedford Park, South Australia, Australia
| | - Jesse Gale
- Department of Surgery & Anaesthesia, University of Otago Wellington, Wellington, New Zealand
- Ophthalmology, Te Whatu Ora Health New Zealand Capital Coast & Hutt Valley, Wellington, New Zealand
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Mehanna CJ, Souied E, Coscas F, Razavi S, Cohen SY. [Update on practice of intravitreal injections. Recommendations of the Fédération France Macula, the Société française de la rétine, and the Club francophone des spécialistes de la rétine]. J Fr Ophtalmol 2023; 46:956-960. [PMID: 37120345 DOI: 10.1016/j.jfo.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/16/2023] [Indexed: 05/01/2023]
Affiliation(s)
- C-J Mehanna
- Centre hospitalier intercommunal de Créteil, 94000 Créteil, France
| | - E Souied
- Centre hospitalier intercommunal de Créteil, 94000 Créteil, France; Fédération France Macula, CHIC, 94000 Créteil, France
| | - F Coscas
- Société française de la rétine, 113, boulevard Saint-Germain, 75006 Paris, France
| | - S Razavi
- Club francophone des spécialistes de la rétine, 2, rue Ambroise-Paré, 75010 Paris, France
| | - S-Y Cohen
- Centre hospitalier intercommunal de Créteil, 94000 Créteil, France; Centre ophtalmologique d'imagerie et de laser, 11, rue Antoine-Bourdelle, 75015 Paris, France.
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Sherry B, Lee S, Ramos Cadena MDLA, Laynor G, Patel SR, Simon MD, Romanowski EG, Hochman SE, Schuman JS, Prescott C, Thiel CL. How Ophthalmologists Can Decarbonize Eye Care: A Review of Existing Sustainability Strategies and Steps Ophthalmologists Can Take. Ophthalmology 2023; 130:702-714. [PMID: 36889466 PMCID: PMC10293062 DOI: 10.1016/j.ophtha.2023.02.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/13/2023] [Accepted: 02/27/2023] [Indexed: 03/08/2023] Open
Abstract
TOPIC Understanding approaches to sustainability in cataract surgery and their risks and benefits. CLINICAL RELEVANCE In the United States, health care is responsible for approximately 8.5% of greenhouse gas (GHG), and cataract surgery is one of the most commonly performed surgical procedures. Ophthalmologists can contribute to reducing GHG emissions, which lead to a steadily increasing list of health concerns ranging from trauma to food instability. METHODS We conducted a literature review to identify the benefits and risks of sustainability interventions. We then organized these interventions into a decision tree for use by individual surgeons. RESULTS Identified sustainability interventions fall into the domains of advocacy and education, pharmaceuticals, process, and supplies and waste. Existing literature shows certain interventions may be safe, cost-effective, and environmentally friendly. These include dispensing medications at home to patients after surgery, multi-dosing appropriate medications, training staff to properly sort medical waste, reducing the number of supplies used during surgery, and implementing immediate sequential bilateral cataract surgery where clinically appropriate. The literature was lacking on the benefits or risks for some interventions, such as switching specific single-use supplies to reusables or implementing a hub-and-spoke-style operating room setup. Many of the advocacy and education interventions have inadequate literature specific to ophthalmology but are likely to have minimal risks. CONCLUSIONS Ophthalmologists can engage in a variety of safe and effective approaches to reduce or eliminate dangerous GHG emissions associated with cataract surgery. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Brooke Sherry
- NYU Langone Health, NYU Langone Hospitals, New York, New York
| | - Samuel Lee
- NYU Langone Health, NYU Langone Hospitals, New York, New York
| | | | - Gregory Laynor
- NYU Langone Health, NYU Langone Hospitals, New York, New York
| | - Sheel R Patel
- NYU Langone Health, NYU Langone Hospitals, New York, New York
| | | | - Eric G Romanowski
- Research Director of The Charles T. Campbell Ophthalmic Microbiology Laboratory, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Sarah E Hochman
- NYU Langone Health, NYU Langone Hospitals, New York, New York; Department of Medicine, Division of Infectious Diseases and Immunology, NYU Grossman School of Medicine, New York, New York
| | - Joel S Schuman
- NYU Langone Health, NYU Langone Hospitals, New York, New York; Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York; Center for Neural Science, College of Arts and Science, New York University, New York, New York; Departments of Biomedical Engineering and Electrical & Computer Engineering, Tandon School of Engineering, New York University, New York, New York; Neuroscience Institute, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York
| | - Christina Prescott
- NYU Langone Health, NYU Langone Hospitals, New York, New York; Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York
| | - Cassandra L Thiel
- NYU Langone Health, NYU Langone Hospitals, New York, New York; Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York.
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