UK's first nurse‑led DSLT clinic opens in Leicester

Glaucoma care is about pressure — specifically the pressure inside the eye that slowly damages the optic nerve. The problem is that treatment often gets bottlenecked by clinic capacity, not just by the disease itself. Leicester’s new nurse-led DSLT clinic matters because it tries to fix that bottleneck, not with a new drug, but with a new workflow. At Leicester Royal Infirmary, Advanced Clinical Practitioner Valentina Clarke is delivering direct selective laser trabeculoplasty in what the trust says is the UK’s first nurse-led service of its kind, and the early claim is simple: waiting lists have been cut in half. (youtube.com) ### What is DSLT, exactly? DSLT stands for direct selective laser trabeculoplasty. It is a laser treatment for open-angle glaucoma and ocular hypertension — basically, conditions where eye pressure is too high or heading that way. The aim is to improve fluid drainage from the eye so pressure falls. Leicester’s patient information says DSLT and standard SLT are both used there and are expected to give sim(youtube.com)act lens on the eye. (yourhealth.leicestershospitals.nhs.uk) ### Why is the “direct” part important? Standard SLT usually needs a special lens sitting on the numbed eye and a clinician who is trained to aim treatment through that setup. DSLT is the stripped-down version. It is non-contact, image-guided(yourhealth.leicestershospitals.nhs.uk) in clinic terms it is huge — less setup, less chair time, and fewer points where only a doctor can do the job. (youtube.com) ### Why does that change who can run the clinic? Because the hard part of older SLT is not just the laser. It is the hands-on technique around it. DSLT was built to remove some of that complexity. Belkin’s Eagle system — now part of Alcon after the acquisition closed — automatically identifies the target area and compensates for eye movement. The whole pitch of the technology is that more eye-care profes(youtube.com)hat Leicester is now testing in routine NHS practice. (glaucomaphysician.net) ### Does the evidence support the idea? Mostly, but with a catch. A 2025 randomized trial found DSLT reduced intraocular pressure and had a safety profile comparable to standard SLT, but a later commentary argued it did not fully clear the bar for noninferiority on the primary endpoint. So this is not a story about a clearly superior laser. It is a(glaucomaphysician.net) care around it. (aaojournal.org) ### Why does Leicester matter beyond Leicester? Because glaucoma services everywhere wrestle with the same math — too many patients, too many follow-ups, not enough specialist time. In the UK, laser treatment already has stronger first-line credibility after studies like LiGHT pushed SLT closer to the front of the pathway. DSLT takes the next step by asking whether the servic(aaojournal.org)s could make laser-first glaucoma care much easier to scale. (myalcon.com) ### So what is Leicester really proving? Not that nurses can replace ophthalmologists. The real test is whether a carefully trained advanced practitioner can take over a narrow, high-volume piece of care without losing safety or outcomes. Leicester’s early result — halved waits — suggests the operational upside is real. Now the longer question is whether other NHS trusts copy the model, and wh(myalcon.com)wider rollout. (youtube.com) ### Bottom line This is a glaucoma story, but it is also a staffing story. Leicester is showing that a faster, less fiddly laser can open the door to task-shifting in a part of eye care that used to stay doctor-only. If that holds up, the bigger innovation will not be the beam — it will be the clinic design.