Eye Care

Cataract removal is one of the most common procedures in the world. The US spends $6.8 billion annually on cataract surgery, and the number is expected to grow as populations age and access to care is expanded. The Thiel Lab began analyzing cataract surgeries in 2014, when Dr. Thiel was awarded a Fulbright-Nehru Academic and Professional Excellence Award for Research to study surgical processes at Aravind Eye Care System in southern India. Aravind was found to perform cataract surgery with better surgical outcomes, at one tenth the waste and one twentieth the carbon footprint. Aravind demonstrates that extreme resource efficiency can still be achieved with excellent quality. This work was awarded “Best Paper” at the 2016 Annual Meeting of the American Academy of Ophthalmology, and has resulted in the inclusion of carbon emissions considerations in the Guidelines for the Cleaning and Sterilization of Intraocular Surgical Instruments produced by the Ophthalmic Instrument Cleaning and Sterilization (OICS) Task Force. 

The Thiel Lab continues to analyze and advocate for sustainability changes in ophthalmic surgeries, with a 2019 study estimating the financial and environmental cost of partially-used, single dose pharmaceuticals from cataract surgeries. Two of the four facilities wasted over $190,000 worth of drugs each month – enough to fund an additional 50 surgeries at each site!


Baseline Research

The Thiel Lab has conducted multiple studies of waste and emissions in cataract surgery and other eye health services.

Best Practices

With international partners, the Thiel Lab is developing tools to develop and distribute global best practices.

Global Advocacy

Dr. Thiel partners with national and global ophthalmic organizations to increase sustainability awareness and action.


As with most translational research, Dr. Thiel and her lab partner with a variety of researchers and eye health organizations, including Drs. Joel Schuman and Jonathan Kahn at NYU Langone Health Eye Center; Dr. David Chang of UCSF; Dr. Alan Robin of Johns Hopkins University; Dr. Venkatesh, Mr. Thulsi and Mr. Vengadesan at Aravind Eye Care System; Dr. Andy Cassels-Brown and Ms. Tanya Harris at the Fred Hollows Foundation; Drs. Dan Morris, John Somner, and Peter Thomas of the UK’s National Health Services; Ms. Inge Steinbach and Rachel Stancliffe of the Centre for Sustainable Healthcare (CSH); the Environmental Sustainability Work Group of the Royal College of Ophthalmologists (RCOphth), the Ophthalmic Instrument Cleaning and Sterilization (OICS) Task Force of the American Academy of Ophthalmology, and the Climate Action Work Group of the International Agency for Prevention of Blindness (IAPB).


© Cassandra Thiel, 2021

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