Sir, I read with interest the clinical study of Welch et al.1 The study highlights the fact that with a decrease in glaucoma surgery trainees have less opportunity for gaining experience in trabeculectomy. I have worked in West Africa for over 20 years and am the medical director of a 62-bed eye hospital in the north of Benin. In 2010 over 3500 eye surgeries were performed, of which 395 were trabeculectomies. Open-angle glaucoma is common and is a major cause of blindness. The potent anti-glaucoma medications used in the United Kingdom are too expensive for our poor patients or are unavailable. In any case, many of the glaucoma patients we see have intraocular pressures of 50 or 60 mm Hg and would not respond sufficiently to eye drops however potent. Hence, surgery is the only practical solution. One possibility for glaucoma surgery training would be for a partnership between hospitals in the United Kingdom and eye hospitals in West Africa, ‘the glaucoma capital of the world'. We have the patients. UK consultants and their trainees would be welcome here for short periods.