Ophthalmology Going Greener: A Narrative Review

Abstract

The combined effects of fossil fuel combustion, mass agricultural production and deforestation, industrialisation and the evolution of modern transport systems have resulted in high levels of carbon emissions and accumulation of greenhouse gases, causing profound climate change and ozone layer depletion. The consequential depletion of Earth’s natural ecosystems and biodiversity is not only a devastating loss but a threat to human health. Sustainability—the ability to continue activities indefinitely—underpins the principal solutions to these problems. Globally, the healthcare sector is a major contributor to carbon emissions, with waste production and transport systems being amongst the highest contributing factors. The aim of this review is to explore modalities by which the healthcare sector, particularly ophthalmology, can reduce carbon emissions, related costs and overall environmental impact, whilst maintaining a high standard of patient care. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-021-00404-8.

Environmental effects of surgical procedures and strategies for sustainable surgery

“…Sustainability applied to health systems is defined by the WHO as a process to “improve, maintain, or restore health while minimizing negative effects on the environment” 63 – 65 . As health professionals working in a high-impact field, surgeons should be proactive and openly promote sustainable surgery.…”

“…However, operating theatres in northern America are unoccupied up to 40% of the time over a 24 h period 5 . For example, in Washington State, USA, a hospital reduced energy consumption by 60% by decreasing ventilation output during inactive periods 63 , 70 .…”

“…In England, 80% of operating theatre waste is generated preoperatively, 90% is misallocated and 40% is potentially recyclable. Thus, implementing and disseminating the recycling process in the operating theatre and beyond is crucial 52 , 63 , 80 .…”

“…However, recycling in the health-care setting presents several challenges. Educating operating theatre staff on waste handling and strict infection control rules will help to overcome the fear of contamination 63 , 81 . A cohort study that evaluated the waste generated by 237 operations concluded that recycling is not associated with additional costs and has several advantages if the practice is globally expanded 82 .…”

Going Green in Ophthalmic Practice

“…Paperless billing, medical record filing and counseling are now possible with advanced practice management software systems [26]. Going paperless saves trees, which can be considered a direct or indirect way to protect the environment [27,28].…”