
EyeSustain is a global coalition of eye societies, organizations, and ophthalmologists collaborating to make ophthalmic care and surgery more sustainable
Our Mission
- Engage, network, and educate our global ophthalmic community about more sustainable practices
- Collaborate with industry to reduce our carbon footprint and surgical waste
- Support research and innovative solutions that reduce ophthalmology’s environmental impact
- Collaborate with other medical specialties to reduce the carbon footprint of our healthcare system
- Support advocacy and education about the public health impact of climate change

Introducing EyeSustain – What and Why?
In this video from the 40th Congress of ESCRS in 2022 in Milan, David Chang, MD, delivers a keynote lecture titled “Reducing Cost and Environmental Impact of our Highest Volume Procedure.” He discusses why we should care about cataract surgery’s carbon footprint - with guidance from the WHO, the Lancet, the Royal College of Surgeons, and other organizations. He mentions literature from the Aravind Eye Hospital, which has an astoundingly low endophthalmitis rate and carbon footprint of cataract surgery and compares these to statistics in the United States. He also describes a recent survey of cataract surgeons’ and nurses’ attitudes toward ophthalmology operating room waste, which demonstrates that 95% of individuals feel that the status quo is not adequate from an environmental and economic sense. He also mentions the impact of realities like general surgery’s rules being applied to ophthalmology and items like lengthy manufacturer instructions for use manuals increasing the size and weight of intraocular lens packaging. The talk also contains a tour of the EyeSustain website.
Needless Waste and the Sustainability of Cataract Surgery
Few health care settings are as regulated as the operating room (OR). Whether cataract surgery is performed in an ambulatory surgery center or a hospital outpatient department, OR licensure, accreditation, and regulatory compliance entail enormous costs. Operating room regulations to prevent surgical infection govern the physical facility (e.g., ventilation), staff (e.g., attire and hand hygiene), protocols (e.g., instrument cleaning and sterilization), and supplies and drugs (e.g., single vs multiuse).
Recent studies from the Aravind Eye Care System (AECS) in southern India demonstrate a significant reduction in the postoperative endophthalmitis (POE) rate following routine adoption of intracameral moxifloxacin prophylaxis. Excerpted from an Ophthalmology editorial by David F. Chang MD.
Continue Reading

The healthcare sector accounts for nearly 9% of all carbon emissions in the United States. Operating rooms (OR) are the single largest contributor to this disproportionately high environmental footprint.
Globally, the institution of rules and requirements that are often not evidence-based may be unnecessarily increasing cost to the healthcare system and patients.
In a survey with more than 1,000 ophthalmologist respondents, 93% felt that OR waste is excessive, 91% were concerned about global warming, and 87% wanted their medical societies to advocate for reducing ophthalmology’s carbon footprint.
Beyond its environmental and financial impact, needless surgical waste may contribute to periodic supply shortages. Having the highest procedural volumes in medicine, ophthalmology has a unique opportunity and obligation to lead efforts to make healthcare more economically and environmentally sustainable. This can have a major impact on global blindness where eye care and surgery in low to middle income countries is often constrained by limited resources.
To learn about the attitudes of eye surgeons and nurses toward surgical waste, a survey was conducted of members of ASCRS, AAO, OOSS, and the Canadian Ophthalmology Society.