Greener Glaucoma; Regional Trends In Glaucoma Services And How We Can Move Towards Are More Sustainable Future

The healthcare sector produces 4.4-5% of global emissions, ranking it equivalent to the fifth largest polluting country on Earth. Building on ESCRS's groundbreaking work on the environmental impact of cataract surgery and sustainable practices, our study aimed to assess the current approaches and attitudes toward sustainability among glaucoma consultants in the Wessex region in the United Kingdom.

This was a survey that consultants at the Wessex regional glaucoma meeting were asked to fill out. 

The consultants were asked to respond to a 16 question survey. The survey included Likert scale questions, simple yes/no questions, and multiple choice questions about current practices within regional glaucoma services, as well as attitudes and approaches to making these services more sustainable.

All eight consultants completed the survey. 75% of respondents had thought about the environmental impact of delivering a glaucoma service. Regarding action taken, 50% were aware of their departments taking steps to reduce environmental impact, while only 37.5% had personally taken such steps in their professional practice. This contrasted sharply with their personal lives, where 87.5% reported making environmentally-conscious changes over the last 2 years. Only 25% of departments had guidelines encouraging fixed drop combinations to reduce waste and improve compliance. However, 87.5% of departments offered laser treatment or minimally invasive glaucoma surgery (MIGS) as alternatives to reduce drop dependence.

Our survey reveals that while we are becoming environmentally conscious in our personal lives, there remains a gap to be bridged to our professional practices. One small change that could improve both patient compliance as well as the environmental impact would be encouragement of fixed drop combinations, which can help reduce manufacturing waste and disposal.

Another area of improvement we recommended, and are implementing locally, is working with pharmaceutical companies to provide medication bottle recycling collection.

An area where departments already performed well was offering laser treatment or MIGS as alternatives to drops - thereby reducing the manufacturing and supply chain emissions associated with topical medications.