Improving Eye Health and Integrating Sustainability

Greetings to our CSH blog readers! My name is Mary, and I’m a recent graduate of the MSc course in Evidence-based Social Intervention and Policy Evaluation from Oxford. I’m working with CSH on building their case library and this month will introduce initiatives to incorporate sustainability into ophthalmology. In relation to National Eye Health Week, for upcoming posts, I will discuss case studies on projects to improve sustainable ophthalmic services.

In a position paper from 2013, the Royal College of Ophthalmologists called for leadership from the profession and the healthcare industry to integrate sustainability into best practice and consider service redesign. Given characteristics of the specialty such as high outpatient volume involving patient journeys for chronic diseases from remote areas and high surgical throughput with high disposable instrument and supporting materials component, ophthalmology as a specialty has a need and responsibility to reduce its carbon footprint. Sustainability in ophthalmology means reducing the environmental and financial impacts, providing positive social impact, and improving quality of care for patients.

This year at the Royal College of Ophthalmologists Annual Congress 2018, entries were evaluated for their approach to sustainable care. The entries were judged on six criteria: relation to the seven steps to sustainable healthcare; environmental, financial, and social impacts; scope of the project; and ease of implementation. The winning entry was CatCam, from Louise Allen’s team based at Addenbrooke’s Hospital in Cambridge. The CatCam technology is able to detect congenital cataracts better than the current screening technique, can address disparities in detection by ethnicity, and provides opportunities for telemedicine.

The fifteen shortlisted entries included a range of projects from investigating access to care for prisoners to changing treatment regimens with “Treat and Extend” to setting up a glaucoma surveillance clinic. Four of the entries focused on the role of the patient from how to empower patients and encourage self-care to emphasising the role of patients in medical education and research. Issues related to referrals and cancellations were addressed in a number of entries. There were also entries that explored how adopting new medical devices and treatment regimens could impact sustainability.

Based on these shortlisted entries, case studies were created to help others learn from projects related to sustainable ophthalmology. They offer a perspective on how to address the four principles of sustainable healthcare: prevention, patient empowerment and self-care, lean systems, and low carbon alternatives.

All of these case studies have been uploaded to the Mapping Greener Healthcare website and can be accessed there.

The Royal College of Ophthalmologists. (2013). Sustainability in Ophthalmology. The Royal College of Ophthalmologists. Retrieved from