Awareness, attitudes, and practices of environmental sustainability in ophthalmology: A national cross-sectional survey in Türkiye

Environmental sustainability has become a critical priority in global healthcare, as medical services substantially contribute to carbon emissions, resource use, and waste generation. Ophthalmology, with its high surgical volume and dependence on disposable materials, represents an important component of this burden. This study aimed to assess Turkish ophthalmologists’ awareness, attitudes, and clinical and surgical practices related to environmental sustainability. A nationwide cross-sectional survey was conducted between January and April 2025 among 640 actively practicing ophthalmologists across diverse clinical settings in Türkiye. The questionnaire included 26 multiple-choice items addressing demographics, sustainability knowledge and training, personal and institutional practices, and attitudes toward surgical materials. Only 10.3% (n = 66) of respondents reported good or very good sustainability knowledge, and 10.8% (n = 69) had received formal training. Younger ophthalmologists demonstrated significantly lower knowledge levels than older colleagues (P = .03). Conversely, senior physicians more frequently agreed that sustainable practices would not increase healthcare costs (P = .007). Although many participants supported implementing sustainability measures in ophthalmology, a considerable proportion indicated they would modify their use of surgical materials if legal restrictions were relaxed. Notably, 69.3% (n = 440) stated that disposable materials were not indispensable for surgical procedures. Although Turkish ophthalmologists demonstrate strong ethical support for sustainability, gaps in knowledge and regulatory constraints limit practical implementation. Targeted education, updated guidelines, regulatory reform, and institutional engagement are essential to advance environmentally responsible ophthalmic care.