Ophthalmology and Optometry
Looking to the future
How is Climate Change Affecting Eyecare?
Climate change is adversely affecting our eyes and visual system. Our eyes, like our skin, are open to the elements and as weather events get more extreme so do the risks to these sensitive organs.
70% of all brain function is concerned with vision, so threats to our brain are likely to have profound effects upon our vision. Increased cardiovascular problems, infections, hyperthermia, dehydration all are worsened by climate change and threaten all our organ systems.
Air and water pollution exposure throughout life increases the risk of chronic diseases, such as cancers, heart and lung disease. Air pollution also delivers irritants to the ocular surface, affecting contact lens wear and patients with dry-eye.
Sight-threatening ocular infections such as trachoma, onchocerciasis and helminthic infections are becoming more prevalent in our warmer world as the organisms and their vectors proliferate. More severe weather such as wind events, flooding and wildfires can directly damage our eyes as well as providing ideal circumstances for infectious agents to proliferate.
The major non-infectious blinding conditions such as age-related macular degeneration, cataract, glaucoma and diabetic retinopathy have all been shown to be more prevalent under the pressures of climate change.
As resources become rarer and more valuable, the products used within Optometry will become more expensive, including, for example, water in the production of spectacle lenses.
How is Eyecare Affecting Climate Change?
From the greenhouse gas emissions of healthcare faculties, to transport to surgical procedures, single use plastics and poor disposal systems, the climate footprint of ophthalmology and optometry is heavy.
Optometry Practices share many of the same environmental issues as Ophthalmology Clinics, but they also sell a product and this adds to the environmental impact. Spectacle frames, lenses and contact lenses each have their own effect on climate change. Each has a complicated supply chain which often makes it difficult to identify products that have a high environmental cost. A spectacle frame is made of many constituent parts, each of which can be made in a different country even if the frame is assembled and labelled from one country.
The storage and supply chain - from manufacture to the customer can also be more concentrated on convenience and speed rather than environmental impact (for example, contact lenses may be sent first to distributers hubs before customers, often creating unnecessary international travel. Large frame manufacturers often have storage facilities that need heat and light, increasing the energy used and the carbon footprint of their product.
As with many environmental issues, the issues are complex and often only reveal themselves only after thoroughly investigating the supply chain. There are also some counter-intuitive observations. For example, a daily disposable contact lens has been shown to have less environmental impact than a monthly disposable contact lens, despite being effectively a single-use plastic. This is largely because of needing disinfectant chemicals and plastic bottles. This information is often not available to patients.
Net Zero Eyecare
Many optometry practices are making sustainability changes. Check out "Net Zero Eyecare" to see if your practice is already involved in sustainability initiatives. If you work in a practice, encourage it to join!
Discussion Ideas with Patients and Colleagues
Patients:
"Have you thought about reusing your spectacle frame for your new prescription?"
"Think about how you dispose of contact lenses and any medications. Avoid flushing anything down a drain as this can pollute our water. You could return your medications or packaging to us to recycle (if facilities are available)."
Colleagues
"How can we reduce the amount of single use plastics that we use?"
"Let's discuss how we can encourage the reuse of spectacle frames."
"Do you think we could promote more environmentally conscientious spectacle manufacturers?"
"EyeSustain" is an online, multi-organisational platform that aims to promote and share resources on sustainable eyecare. Check out the website below:
Highest Impact Actions for Optometry and Ophthalmology Departments
Introduce "Climate Crisis and Healthcare Sustainability" as a standing item on all governance meetings
If working in a private practice, review the practice banking policies and support a switch to a more sustainable bank
Learn from other units, using platforms such as EyeSustain and Net Zero Eyecare
Reduce single use utensils wherever possible
Consider staff and patient transport, and whether active travel and public transport can be promoted
Check out Real Zero for information regarding switching to a sustainable bank
For More Information
Check out the Royal College of Ophthalmologists sustainability resources, and visit the Centre for Sustainable Healthcare Ophthalmology network