I teach and practice in the large metropolis of Karachi, Pakistan, population 20 million and a high prevalence of both primary and secondary glaucoma. On the other side of the globe, for the past many years I had been following the work of Glaucoma Associates of Texas. It intrigued me that this group of seven outstanding clinicians and surgeons was able to spearhead innovation and push the boundaries of clinical care with courage, grit and grace, changing our thinking of how we approach surgical care in glaucoma. Almost 10,000 miles away from where they were situated, I had been following them in particular for a procedure that Dr. Davinder Grover and Dr. Fellman had first invented and performed in 2012. This procedure, nearly eponymous with the name of their own group GAT was abbreviated GATT or gonioscopy assisted trans luminal trabeculotomy. To my mind, this was a procedure which presented a chance to provide definitive surgical care where it was indicated without exposing patients to concurrent risks of more traditional glaucoma surgical procedures.
I flew across to spend two weeks with the GAT group, in February this year, just before the pandemic hit. The logistics of my time at Glaucoma Associates of Texas optimized graciously and productively by Dr. Grover despite his hectic clinical and surgical commitments. I have to say these weeks, hour for hour, were amongst the most fulfilling times of my professional career. Even though I had been in practice for twenty years, in those two weeks, I re-lived another opportunity to be a fellow once again. The excitement, the wonder and the incredible sense of satisfaction at learning something new every day, and sometimes every hour is deeply gratifying. Knowing that the skill and clinical wisdom gained from this remarkable repository of expertise would translate into immediately actionable changes for my own clinical practice once I returned to Pakistan, made the experience especially relevant.
