Addressing the environmental sustainability of eye health-care delivery: a scoping review

John C. Buchan, Cassandra L. Thiel, Annalien Steyn, John Somner, Rengaraj Venkatesh, Matthew J. Burton, Jacqueline Ramke

Research output: Contribution to journalReview articlepeer-review


The demand for eye care—the most common medical speciality in some countries—is increasing globally due to both demographic change and the development of eye health-care services in low-income and middle-income countries. This expansion of service provision needs to be environmentally sustainable. We conducted a scoping review to establish the nature and extent of the literature describing the environmental costs of delivering eye-care services, identify interventions to diminish the environmental impact of eye care, and identify key sustainability themes that are not yet being addressed. We identified 16 peer-reviewed articles for analysis, all published since 2009. Despite a paucity of research evidence, there is a need for the measurement of environmental impacts associated with eye care to be standardised along with the methodological tools to assess these impacts. The vastly different environmental costs of delivering clinical services with similar clinical outcomes in different regulatory settings is striking; in one example, a phacoemulsification cataract extraction in a UK hospital produced more than 20 times the greenhouse gas emission of the same procedure in an Indian hospital. The environmental costs must be systematically included when evaluating the risks and benefits of new interventions or policies aimed at promoting safety in high-income countries.

Original languageEnglish (US)
Pages (from-to)e524-e534
JournalThe Lancet Planetary Health
Issue number6
StatePublished - Jun 2022

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health(social science)
  • Health Policy
  • Public Health, Environmental and Occupational Health


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