*2.1.1 Establishment of the Coronicle*

During the COVID-19 pandemic, the pre-COVID waiting hall of approximately 450 square feet was converted into a state-of-the-art investigation coronicle of 256 square feet for comprehensive ocular examination (**Figure 1**). Dimensions of the coronicle were 16 feet in length, 16 feet in breadth, and 8 feet in height; since only a minimal area was utilized for patient examination, the usage of electricity was reduced greatly, contributing to environmental sustainability. Acrylic sheets, aluminum beading, fevicol, araldite paste, and a jigsaw cutting blade were used to build the coronicle in a do-it-yourself (DIY) template. A detailed cost analysis of the materials and the total cost of setting up the coronicle are provided in (**Table 1**) [24]. There are two slit lamps, two electronic medical records (EMR) computer systems, and one auto refractometer, lensometer, confocal fundus capture device, spectral-domain optical coherence tomography (OCT), optical biometer, manual keratometry, corneal topography, and non-contact tonometer (NCT) encompassed inside the coronicle (**Figure 2**), which were interconnected via local area network (LAN). The coronicle has proved to be effective over a period of two years (June 2020–July 2022) with the majority of the patients only needing the services available within the coronicle (p = 0.00). **Table 2** provides the details of the number of patients requiring the services available within and outside the cubicle during this time period.

**Figure 1.** *Image showing the coronicle (corona + cubicle) in the pre-COVID waiting hall.*


#### **Table 1.**

*Materials used for assembly the cubicle and their cost dynamics.*

#### *2.1.2. Go green with Coronicle*

As all the ophthalmic instruments need maintenance via good air conditioners for their longer sustainability, keeping each instrument in a different room ends up with a great amount of electricity consumption as well as a higher number of manpower, which is a major contributor to the carbon footprint. Air conditioners release potent greenhouse gases into the air causing insulation of our planet; it is a major contributor to global warming. Before the implementation of the coronicle, the total electricity consumption of the hospital was approximately 22,000 kilowatts per month, which has effectively reduced after the implementation of the coronicle to approximately 13,000 kilowatts per month. So, instilling all the gadgets in a single coronicle can effectively reduce the usage of the number of air conditioners as well as the number of tube lights, which in turn can reduce the consumption of electricity and can lead to a climate-friendly and energyefficient healthcare facility. This way eye care hospitals can take initiative to address global environmental health for the future and present-day generations.

#### **2.2 Local area network (LAN)**

#### *2.2.1 Features of LAN*

Similarly, during the pandemic, along with the coronicle, we were able to optimally utilize LAN, which interconnects all the ophthalmic gadgets to the personal computer (PC) (**Figure 3**). As a result, it amplifies the functionality of holistic eye examination using a single internet connection [25]. In cases with multi-modal imaging and testing, LAN plays a vital role by not only connecting the devices but also providing in-depth data without compromising on quality.

#### *2.2.2 Setting up the LAN framework*

The LAN networking is implemented by a sixteen-port switch (**Figure 4a**) present inside the coronicle which is connected to the CISCO (Commercial and Industry

#### **Figure 2.**

*All the essential ophthalmological instruments required for an eclectic setup inside the coronicle (a) optical biometry (b) optical coherence tomography, (c) corneal topography, (d) manual keratometry, (e) non-contact tonometer, (f) confocal fundus photography, and (g) slit lamp biomicroscopy.*

Security Corporation) switch (**Figure 4b**) inside the server room placed in a 6 U rack. CISCO allows the connected devices to share information and communicate with each other on the same network inside the building for high-security purposes. LAN also link wireless access points, printers, xerox machine, scanners and servers on the same network for extra facilities. Each ophthalmic gadget has a unique IP address; for example, 192.168.1.16 has been given to the fundus capture device, and its associated computer has an IP address of 192.168.1.15. An IP address can be set by following these three simple steps (Control Panel- > Network and Internet- > Network Connections- > Use the following IP address). In this example, we have assigned an IP address of 192.168.1.16. Once the IP address is allotted for that specific gadget, the same address is entered in the web browser of the PC desktop placed near the doctor's slit lamp for activating the screen-sharing relay display from the machine (**Figure 5**).


#### **Table 2.**

*Total number of ocular examinations at various stations performed inside and outside the cubicle.*

*Going Green in Ophthalmic Practice DOI: http://dx.doi.org/10.5772/intechopen.107328*

#### **Figure 4.**

*(a) Sixteen-port switch connections to/from various gadgets. (b) Commercial and industry security corporation (CISCO) switch (yellow arrow indicates the 28 ports in CISCO).*

#### **Figure 5.**

*Image showing LAN connection of fundus capture device after entering the IP address in the web browser.*

All eye care professionals can invest in LAN, as it is relatively more cost-effective than a high-end EMR system. The costs of the CISCO server with the switch are approximately 1,00,000 INR/1046.82 GBP and approximately 10,000 INR/104.68 GBP for the sixteen-port switch. The wiring cost depends upon the area covered.

#### *2.2.3 Role of LAN in go green ophthalmic practice*

The reports of every patient can be accessed and viewed immediately after the completion of the full evaluation. Also, they can be compared side by side with their former baseline and other examinations. This aids as a smart time-saver. For instance, the time can be reduced considerably, as doctors need not visit each investigative machine to see the respective patient's data and patients can be counseled by showing their image, sitting in one place. At last, the patient's report can be sent by mail or WhatsApp, so they can carry the soft copy for future reference everywhere and anytime. EMR systems require huge storage servers which consume a significant amount of energy, whereas LAN provides better functionality without compromise.

Paperless billing, medical record filing and counseling are now possible with advanced practice management software systems [26]. Going paperless saves trees, which can be considered a direct or indirect way to protect the environment [27, 28].
