Most people feel little or no pain. Numbing drops are used before the laser.

How soon does pressure drop?

The effect builds over weeks. Your doctor checks pressure later to decide whether it worked well enough.

Will I stop glaucoma drops after the laser?

Maybe, but not always. Drops are reduced only if your pressure stays at your doctor's target.

Who should not have this laser?

It may not fit eyes with closed angles, active inflammation, infection, or a cloudy cornea that blocks the laser view.

Treatment

Direct Selective Laser Trabeculoplasty

Also known as Direct SLT, DSLT, Automated Laser Trabeculoplasty, Noncontact Glaucoma Laser

Updated May 16, 2026·For educational purposes only. Not a substitute for medical advice. See our terms.

Bottom Line

Direct selective laser trabeculoplasty is a non-contact office laser for open-angle glaucoma. It lowers eye pressure by treating the eye's natural fluid drain.

Direct selective laser trabeculoplasty is a newer way to deliver glaucoma laser treatment without a mirrored contact lens on the eye. The laser is aimed through the clear front window of the eye ¹.

Like standard selective laser trabeculoplasty, it targets pigmented cells near the eye's drain. This can help fluid leave the eye and lower pressure ².

A randomized noninferiority trial found direct selective laser trabeculoplasty had pressure lowering similar to standard selective laser trabeculoplasty in open-angle glaucoma and ocular hypertension ³.

How It Works

Direct selective laser trabeculoplasty treats tissue near the eye's drain, where fluid leaves the front of the eye. It uses short laser pulses and does not make a cut ².

The main difference from standard selective laser trabeculoplasty is delivery. Standard laser uses a mirrored contact lens on the eye. Direct treatment is designed to work without that lens ¹.

Risks And Side Effects

Side effects are usually mild. They can include temporary redness, blurry vision, light sensitivity, inflammation, or a short pressure rise after laser ³.

The laser may not lower pressure enough. Some people still need drops, repeat laser, or surgery.

Cost And Insurance

Coverage depends on your diagnosis, your insurer, and whether the device is available at the practice. Ask for a written estimate before treatment.

Questions to ask include the laser fee, follow-up visit costs, and whether both eyes are treated on the same day.

Common Questions About Direct Selective Laser Trabeculoplasty

It is closely related, but the delivery is different. Direct treatment is designed to avoid the mirrored contact lens used in standard selective laser trabeculoplasty.

Next Steps

1Ask your glaucoma specialist whether direct selective laser trabeculoplasty is available.
2Confirm that your glaucoma type is open-angle before scheduling.
3Ask how your pressure target will be checked after treatment.
4Get a written cost estimate from the practice and your insurer.
5Keep taking glaucoma drops unless your doctor tells you to stop.

Find specialists for Direct Selective Laser Trabeculoplasty

Board-certified ophthalmologists who treat Direct Selective Laser Trabeculoplasty.

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