August 08, 2025
2 min read
Key takeaways:
- The health care system contributes more to greenhouse gases than the aviation industry.
- Reduce, reuse, recycle and rethink in your ophthalmology practice.
AMELIA ISLAND, Fla. — Health care contributes significantly to global carbon emissions, so two clinicians speaking at the Women in Ophthalmology Summer Symposium shared five recommendations for reducing that footprint.
Emily Schehlein, MD, a glaucoma and cataract surgeon with Brighton Vision Center, Ann Arbor, Michigan, said the global health care system contributes 5% of greenhouse gases.
Emily Schehlein, MD, (left) and Mahsaw Mansoor, MD, urged attendees at the Women in Ophthalmology Summer Symposium to evaluate their practices and improve sustainability. Image: Nancy Hemphill, ELS, FAAO / Healio
“That’s more than the aviation industry,” she said.
Cataract surgery is the most commonly performed surgery in the world, Schehlein said.
“We are high-volume proceduralists, so we have a responsibility here to try to reduce the amount of waste and carbon emissions we produce,” she said.
The biggest barrier to this is regulatory, Schehlein said, compounded by inertia and inconsistency across states and countries.
“A lot of the pushback about ways we could be more sustainable in ophthalmology is based on safety,” she said. “We need to be sure we’re following evidence-based medicine. Sometimes the perception is that single use is better, which the data shows is not always the case. We need specialty-specific carbon footprint data. Lifecycle assessments are a way that we are able to understand the carbon footprint of a particular procedure, and they are very expensive.”
Mahsaw Mansoor, MD, of Advanced Vision Care, Los Angeles, shared “five things you can do on Monday to make a difference.”
Start by trimming your custom cataract packs, she said.
“There’s so much you’re not using in your surgical pack,” Mansoor said. “Do a 2-week audit. You would be amazed at how much you don’t use that you’re paying for. If you inventory what you’re using you’ll decrease your emissions just in your surgical pack by over 30%.”
Replace full-body drapes.
“It’s ridiculous,” Mansoor said. “You do not need a full-body drape. Smaller drapes are safer, cheaper and greener, and patients are more comfortable.”
Track your footprint and share.
“There’s an easy way to audit yourself through EyeSustain,” Mansoor said.
She also recommended SIDICS, or the Sustainability Index for Disposables in Cataract Surgery, available at ESCRS.org/SIDICS, and the Zasti Carbon Calculator.
“It’s very easy to inventory what you’re doing day-to-day and measure your carbon footprint,” Mansoor said.
Follow the basics of an energy-efficient practice.
“This is back to the basics of what we learn in elementary school: Reduce, reuse, recycle, but I challenge you to also rethink,” she said. “Prevention is wonderful, but we have to reduce. You can recycle things in the OR. Towels, batteries, energy recovery. Turn off the slit lamps and microscope. Be mindful of water use. Do you really need the OR to be 60 degrees?”
Switch to an alcohol-based scrub.
“This is a big shift in your day-to-day practice,” Mansoor said. “Maybe start with a morning water-based scrub. In between patients you should be using waterless. This has been proven to be safe and effective. It saves you time, it saves you money.”
One OR can save 60,000 liters of water by making this change, she said.
“This is your to-do list for Monday,” Mansoor said. “Just pick one.”
Sources/Disclosures
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Schehlein E, et al. The environmental footprint of ophthalmology: Challenges and opportunities. Presented at: Women in Ophthalmology Summer Symposium; Aug. 7-10, 2025; Amelia Island, Florida.
Disclosures:
Mansoor and Schehlein report no relevant financial disclosures.
