A Game-Changer for Glaucoma: An Impactful Trip to Belize

It is April 5, 2025 and I am on my way home after spending a week in Belize. As usual, I started working the day I arrived, visiting a different clinic each day. It felt like many of the thirty-plus trips I’ve taken there—except for one major difference that I believe will change the trajectory of glaucoma care in the country: this time, I brought a Selective Laser Trabeculoplasty (SLT) machine.

On a previous trip, I learned that glaucoma is the second leading cause of blindness in Belize, after cataracts. Known as the “silent thief of sight,” glaucoma is a progressive optic neuropathy that leads to irreversible vision loss if left untreated. In countries like Belize, where healthcare resources are limited, the burden of this disease is especially severe. The introduction of an SLT machine could revolutionize glaucoma care by offering a more accessible, affordable and sustainable treatment option.

Traditional treatment relies on medications or surgery—difficult to manage in resource-limited settings. Medications require regular access and adherence, and surgeries demand skilled personnel and postoperative care, often only available in urban centers. SLT offers a non-invasive alternative: it targets the trabecular meshwork to improve aqueous outflow, lowering intraocular pressure (IOP) effectively, without daily medications or complex procedures. It’s portable, low-maintenance, and can treat many patients in a single day.

On this trip, we used the SLT machine not only in Belize City but also in Orange Walk, Dangriga, and Belmopan—reaching patients who would otherwise have no access to this level of care. SLT reduces the need for costly medications and repeated travel, making it a practical solution for underserved communities.

A single SLT session can lower IOP for months or even years, often eliminating the need for daily eye drops. SLT is both effective and cost-efficient, benefiting patients and healthcare systems alike. Studies show SLT is just as effective as topical medications, and it doesn’t rely on patient compliance, which can be a major hurdle in areas with low health literacy or limited follow-up care.

Perhaps most importantly, SLT aligns with the realities of developing nations. It works as a first-line therapy and remains effective even in advanced cases. By incorporating SLT into primary eye care and training local providers to use it, we can create a sustainable model of treatment and empower communities to combat glaucoma at scale.

I’m especially grateful to Dr. Shelby Gelhaus for her invaluable help in screening patients prior to treatment. I hope this new treatment approach brings lasting hope to those affected by glaucoma in Belize.