1. In 1994 published two of the initial papers to discuss risk factors for sub-conjunctival fibrosis that leads to failure of surgical drainage surgery . These papers have been cited over 800 times in the literature since then
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In 1994 with Roger Hitchings, David Broadway and Ian Grierson we published 2 ‘sister’ papers in Archives of Ophthalmology in the same month highlighting the adverse effects of chronic topical glaucoma eyedrops on the inflammatory profile of the conjunctiva and on the outcome of glaucoma trabeculectomy surgery (Broadway et al Arch Ophthalmol 1994:; 1437 -1445 and 1446-1454).
They were one of the first papers to discuss risk factors for sub-conjunctival fibrosis that leads to failure of surgical drainage surgery. My role in the project was to recruit the majority of the patients for the study and collected the conjunctival specimens for histolological assessment. The increased awareness of these risk factors has had a significant impact of glaucoma surgery outcomes in the intervening years
2. In 2003 published a study on quality of life in glaucoma and its relationship with visual function. The paper have been cited over 284 times and our questionnaire has been translated into several languages
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In 2003, with Peter Aspinall we published a study on quality of life in glaucoma and its relationship with visual function (Nelson P et al, J Glaucoma;12:139-50). We developed a new questionnaire (GQL-15) which identified that cetain everyday tasks (involving dark adaption and disability glare, outdoor mobility tasks) were significantly correlated with the severity of binocular visual field loss. The questionairre was subsequently used by numerous other research groups for application in quality of life studies and was translated into several languages.
3. 2011-2013 Elected and Chaired the Glaucoma Section of the ARVO program committee and organised the 2013 ARVO Glaucoma Annual Meeting in Seattle
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I was elected by the members of the Glaucoma Section of the Association for Research in Vision and Ophthalmology (ARVO) to serve on the annual meeting Program Committee for a three year term 2011-2013.
Every year the Programme Committee reviewed approx 800 submitted Abstracts, and put together the Paper and Poster Sessions into the various topics. During my year as Chair of the committee I organised the main Symposium at the 2013 Annual Meeting held in Seattle on ‘Fibrosis in Glaucoma’.
4. Team member of the Royal College of Ophthalmologists (UK) that produced the first version of ‘Clinical Guidelines for the Management of Open Angle Glaucoma and Ocular Hypertension’
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In 1997, I served on the a Working Party (with 4 other consultant colleagues) of the Royal College of Ophthalmologists (UK) to produce the first version of Clinical Guidelinse for the Management of Open Angle Glaucoma and Ocular Hypertension’ .
These guidelines were seen as a consensus document derived from clinical experience and evidence from clinical trials to help guide the management of glaucoma patients for the non-specialist.
5. Committee member of 2 large multicentre UK MRC Trials
i) 1998 –2003 : ‘5-Fluoruracil Glaucoma Surgery Trial’
ii) 2010 -2015 : ‘EAGLE Effectiveness in Angle Closure Glaucoma of Lens Extraction Trial’
- Chaired the Steering Committee for the NIHR Health Technology Assessment (UK) GATE Study
2010-2015: ‘Glaucoma Automated Tests Evaluation’
The outcome of these studies demonstrated that
At the time of glaucoma surgery adjunctive 5_FU improved longterm pressure control and visual field
Lens extraction was the most effective approach to longterm ocular pressure control for narrow angle glaucoma
Automated imaging was effective to aid glaucoma diagnosis referred from the community to the eye hospital