Sustainability Recommendations for Glaucoma Practice

Amanda Gallagher, Senior Editor

Glaucoma Today

Key Takeaways Glaucoma care delivery is a contributor to environmental waste in health care, but small changes can lead to a more sustainable practice. Glaucoma specialists can consider transitioning to reusable devices, limiting excess packaging, reducing pharmaceutical waste, and taking steps to decrease the transportation required for patient care. The Ophthalmic Instrument Cleaning and Sterilization Task Force supports the use of topical drugs in multidose containers on multiple patients and continuing use until the labeled expiration date. Health care delivery often comes with the undesirable side effect of excess waste, both in the clinic and the OR. Glaucoma care is no exception. However, small, incremental changes can go a long way toward creating a more environmentally sustainable glaucoma practice. “As the disease burden of glaucoma rises, so [does] the number of glaucoma patient clinic visits, procedures, and surgeries,” Aakriti Garg Shukla, MD, of Columbia University Irving Medical Center in New York, said in a recap of her presentation on the topic of sustainability at the 2026 AGS Annual Meeting (see Sustainability Efforts in Glaucoma Practice). “Because we see patients frequently and operate often, glaucoma specialists have an outsized opportunity to make a meaningful impact.” Glaucoma specialists commonly perform procedures that entail the use of single-use instruments, packaging, and pharmaceuticals as well as disposable attire. When safe and appropriate, they can consider transitioning to reusable devices and reducing excess packaging, Dr. Shukla said.

Influencing Office Culture and Success

Following these four steps enabled me to make a significant impact as a new graduate.

Noa Robson, OD, MBA, FAAO

Modern Optometry

Real Estate: Invest in the Future of Your Practice

These financial, operational, and strategic considerations can help you make the right decision between renting and owning.

Jefferey T. Brockette, MSHA

Retina Today

Key Takeaways Real estate decisions don’t sit in one lane; they touch operations, finance, strategy, and even culture. Talking through different real estate structures with multiple advisors—rather than relying on input from a single source—often reveals options that make the path forward feel more manageable. Hybrid real estate structures can take several forms, including physician ownership alongside outside capital partners, joint ventures with developers or health systems, or staggered buy-in models that allow newer partners to participate over time. For most retina specialists, investing in real estate is a major decision. However, the question isn’t whether it makes sense—it’s how to approach it in a way that fits your practice. It’s important to recognize that real estate decisions don’t sit in one lane; they touch operations, finances, strategy, and even culture. Without a carefully constructed strategy to go about purchasing real estate, it may become easier to over-analyze every deal or put it off entirely. When making important real estate decisions, start by focusing on three crucial areas: strategy, financial structure, and operations. Within each of these three areas, explore at least three options, rather than relying on one perspective. PRACTICE CULTURE Ownership tends to create a stronger sense of alignment and long-term commitment among physicians, particularly when they are participating in both the practice and the real estate entity.