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Subspecialties Other, Cataract

An Eye on Our Planet’s Future

Although I don’t consider myself an ‘earth mother’, I do care – and worry – about the fate of our planet. My household recycles, I drive an economical car, and I am mindful of reducing waste overall. In my local town, I was pleased to see a collective ban on plastic drinking straws issued, and many bars and restaurants now offer cheerfully striped cardboard straws. Even McDonalds are “responding to customer feedback” by ditching the disposable plastic straw. Similarly, many groups are calling to end the use of plastic cutlery, cotton buds, and a whole array of disposable plastic items.

Why am I sharing stories of plastic drinking straws and cotton buds with an audience of ophthalmologists? Because I recognized that sustainability should extend to all practices – from the routine and mundane to the most specialized – including ophthalmology. In our June issue, we sat down with Alan Crandall, who made an interesting point about attitudes to waste and recycling when asked what we could learn from developing countries: “Over there, there’s no such thing as a single-use instrument, but their complication rate is no higher than ours; do we really need to focus on disposables so much?”

Does ophthalmology focus too much on disposables? Certain instruments and equipment necessitate being disposable because of the nature of their use – and unsuitability for decontamination. But I am left wondering if more could be done to ‘green up’ ophthalmology – whilst still achieving favorable outcomes for patients, of course. Surely, there is more scope for reuse and recyclability of some instruments, as well as their packaging. A study of cataract surgery waste reported that three participating US medical centers generated 2.3–3.9 kg of waste per phacoemulsification case – 100 percent of which was either landfill or biohazardous material. Contrast that with the Aravind Eye Hospital in India, which generated 0.25 kg of waste per case on average – of which two-thirds was recycled (2).

It seems as though there could be more than a few ways to reduce ophthalmology’s ecological footprint, and I’d be surprised if there weren’t any environmentally-conscious institutes and clinics out there who are already making efforts to reduce waste. In this ever-changing world, where environmental issues are becoming increasingly important to many, it will be interesting to see how general attitudes might change – and how industry may follow suit.

Ruth Steer


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  1. Alan Crandall, “The Selfless Surgeon”, The Ophthalmologist, 54, 50–51 (2017). Available at:
  2. Miriam Karmel. “Reducing waste in cataract surgery”. Accessed June 21, 2018. Available at:
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Ruth Steer

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