The concept of "Carbon Sustainable Ophthalmology" was explored on 15th May at a satellite meeting of the Royal College of Ophthalmologists. The event was organised by specialist trainee Aditi Das from Leeds, working with ophthalmic surgeon and consultant in community eye health, Mr Andy Cassels-Brown. As a first 'sustainable specialty' meeting, it was impressive in the quantity of relevant data presented - including a carbon footprint study of cataract surgery.
Worldwide, as Mr Cassels-Brown pointed out, climate change can be predicted to have a significant impact on eye disease, particularly trachoma, malarial disease, and increased incidence of cataracts due to diarrhoea/dehydration in water-stressed areas or as a result of extreme weather events.
Meanwhile, in developed countries, a sustainability lens highlights opportunities to cut back on needless waste in eye care. John Somner, specialist trainee in Cambridge, put forward ideas ranging from reuse of equipment (such as tenometer heads and phaco-casettes) to redesign of clinical services (such as the introduction of a mobile unit for age-related macular degeneration in York). Even simple changes can provide useful savings, such as installation of knee-operated taps in scrub-rooms, which has been shown to save 6L of hot water on every surgical scrub.
The group agreed on the importance of verifying the net carbon impact of innovations, since knock-on effects can sometimes negate carbon savings. With this in mind, Mr Daniel Morris, oculoplastic consultant in Cardiff, presented unpublished results of a recent carbon footprint study of cataract surgery. The study suggests that cataract operations across the UK may be collectively responsible for over 50,000 tonnes CO2e each year. As with the wider NHS carbon footprint, supply chain emissions form the largest component.
Additional speakers included me (sharing experience from the Green Nephrology programme), Mr Gok Ratnarajan (who showed data on patient travel linked to a glaucoma referral pathway), Dr Ruth Passman (of the NHS Sustainable Development Unit) and Mr Andrew Baker (speaking on behalf of the industry group, Spectrum UK).
Ophthalmology clearly harbours an impressive group of forward-thinking and sustainability-literate individuals. It was exciting to be present for their first formal exchange of ideas and data. As the meeting ended, alliances were just beginning and tactics unfolding for a Sustainable Eye Care movement…
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