Please enjoy the following letter from Dr. Mahnaz Shah of Karachi, Pakistan, to the physicians of Glaucoma Associates of Texas which thanks them for their time, effort and training. Because of Dr. Shah's participation in the Cure Glaucoma Foundation's Fellowship Program, she can use her training to train other doctors in her home city and benefit even more glaucoma patients across the world.
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.
My time with the Glaucoma Associates of Texas, in their clinics, operating rooms and their impromptu huddle sessions bringing collective wisdom and expertise to immediately converge to a crisp focus in solving complex clinical challenges was memorable in every capacity.

Dr. Grover, Dr. Fellman and Dr. Smith, with whom I spent the most time, impressed me not only with their skills but also with their tremendous generosity of spirit and their deep commitment to improving the care of glaucoma patients not only locally and nationally but wherever in the world glaucoma patients may be. T heir ongoing support, since my return to my practice, whenever I have reached out to them to discuss a case and their ability to so graciously share their insight and expertise is the foundation of what makes meaningful transfer of surgical education and global outreach viable. The joy they share with me at newer and safer procedures going well for my patients is palpable to me thousands of miles away.  These procedures are not only a first for my patients but in a country of 212 million, the first for Pakistan. Both my patients and I owe a debt of gratitude to GAT for GATT and so much more.

Mahnaz Naveed Shah, MD
Karachi, Pakistan
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