Mr Geraint Williams BSc, MBBCh, FRCOphth, PhD

 

Honorary Clinical Research Fellow

School of Immunity and Infection

geraint-williams

Contact details

School of Immunity and Infection
College of Medical and Dental Sciences
University of Birmingham
Edgbaston
Birmingham
B15 2TT
UK

About

Geraint Williams is an honorary clinical research fellow at the School of Immunity and Infection, College of Medical and Dental Sciences and currently undertaking a clinical research fellowship at the Singapore Eye Research Institute (SERI). His sub-specialist area is in cornea and external disease, with an interest in ocular surface immunity and infection. He was awarded a Wellcome Trust clinical research fellowship in 2008 and completed his PhD in Immune Regulation of Acquired Ocular Immunobullous Disease in 2012. He was an NIHR Academic Clinical Lecturer in Ophthalmology from 2012 to 2014. Geraint is currently combining his research work at SERI with his clinical fellowship in the cornea and external eye disease department of the Singapore National Eye Centre (SNEC) with Professor Donald Tan and Associate Professor Jod Mehta.

Geraint is enthusiastic about imparting knowledge of ocular surface disease, reflected in his commitment to publishing in the field of ophthalmology, communicating with scientific audiences at regional, national and international meetings and talking with lay audiences such as at the British Science Festival, Moorfields Eye Hospital and for the University of Birmingham.

Qualifications

  • FRCOphth, Royal College of Ophthalmologists 2013

  • PhD, University of Birmingham 2012

  • MRCOphth, Royal College of Ophthalmologists 2005

  • MBBCh, University of Wales College of Medicine (UWCM), Cardiff 2002
  • BSc (Hons) Medical Genetics, UWCM, Cardiff 2001

Biography

Geraint graduated from the University of Wales College of Medicine (UWCM), Cardiff in 2002, gaining a distinction for his final MB after undertaking a BSc in Medical Genetics in 2001. He completed his basic specialist training in ophthalmology in the Oxford deanery while gaining membership of the Royal College of Ophthalmologists in 2005. He took up a position as a specialist registrar in the West Midlands in 2006 before securing a Wellcome Trust clinical research fellowship in 2008.

He completed his PhD on the Immune Regulation of Acquired Ocular Immunobullous Disease at the University of Birmingham in 2012. Geraint’s work in to blinding ocular surface scarring diseases has been recognised with an Association for Research and Vision in Ophthalmology international travel grant, a Midland Ophthalmological Society centenary meeting junior ophthalmologists prize in 2012 and the Fight for Sight Award in 2013. He has also been an invited speaker at the Royal College of Ophthalmologists showcase session and academic ophthalmology & translational research session at their annual congress.

Geraint was appointed as an NIHR Academic Clinical Lecturer in Ophthalmology in 2012. He completed his advanced subspecialty training opportunity in cornea and external disease at the Birmingham and Midland Eye Centre and continued his senior anterior segment training at the Queen Elizabeth Hospital Birmingham and Moorfields Eye Hospital, London. He became a fellow of the Royal College of Ophthalmologists in 2013.

Teaching

Postgraduate supervision

Geraint is interested in co-supervising doctoral research students in the areas of human ocular surface immunity and infection.

If you are interesting in studying any of these subject areas please contact Geraint on the contact details above, or the Head of the Academic Unit of Ophthalmology, Professor Murray on p.i.murray@bham.ac.uk.

For a full list of available Doctoral Research opportunities, please visit our Doctoral Research programme listings

Research

Research themes

  • Ocular Surface Immune Regulation in Health and Disease,
  • Improved Measurement of Clinical Disease Activity and Damage,
  • The Role Of Femtosecond Lasers In Improving Outcomes in Anterior Segment Surgery

Research activity

Ocular Surface Immune Regulation in Health and Disease

Geraint has explored the use of rapid, non-invasive ocular surface impression cytology (OSIC) combined with multi-colour flow cytometry to characterise conjunctival leukocytes. This has provided an insight in to immune regulation in health, ageing and ocular surface diseases (OSD). In healthy individuals, CD8αβ+ effector memory, cytotoxic, mucosal-homing T cells, capable of recognising herpetic viruses are the dominant population in the normal conjunctiva. This population is unaltered with age but other populations such as CD4+ T cells, capable of producing IFN-g do increase, indicating a potential role in healthy ageing.

During his PhD, Geraint studied a blinding condition called Ocular Mucous Membrane Pemphigoid (OcMMP), an autoimmune immunobullous disease resulting in conjunctival inflammation and corneal scarring. A major challenge in OcMMP is the observation that scarring may take place without typical signs of inflammation, namely conjunctivitis. By using OSIC in a cohort of patients with OcMMP, an elevation in inflammatory neutrophils were observed and this was associated with progression of scarring, even in the clinically non-inflamed eye. It is hoped that this can be translated in to more effective therapeutic intervention by exploring neutrophils as a biomarker of sub-clinical inflammation and their role in the scarring process.

Following his PhD, Geraint has worked on determining a better understanding of immune regulation of the ocular surface infections including T cell recognition and regulation of Herpes Simplex Keratitis (HSK). HSK is an important disease as the Herpes Simplex Viruses (HSV) are responsible for ocular disease including recurrent HSK or inflammation of the cornea. This results in blinding complications including diminished corneal sensation, corneal scarring, the formation of abnormal corneal blood vessels and secondary bacterial infection. He is optimising ex vivo quantification of peripheral T cell HSV epitope recognition and memory status and determining whether they differ in those with and without HSK, in the hope of targeting therapy more effectively.

Improved Measurement of Clinical Disease Activity and Damage

Along side his laboratory work in to the immune regulation of the ocular surface, Geraint has an active interest in improving the clinical phenotyping of human ocular disease. He has previously developed and validated a tool to measure the scarring process in cicatrising conjunctivitis such as OcMMP. This tool has been employed to undertake an anthropological study in to the normal anatomy of the conjunctival fornices in Caucasians.

Geraint has helped establish a steering committee of ocular surface experts from around the UK in order to define activity and damage indices in disease. This has employed a Delphi process among anterior segment and corneal specialists to determine clinical parameters of OSD clinical scoring systems by establishing clear distinctions between activity and damage indices, and validating rankings of disease scales in order to standardise clinical scoring systems for use in clinical trials.

Geraint is working to improve detection and classification of ocular surface infections such as HSK through imaging platforms, including the role of in vivo confocal microscopy to determine corneal changes including nerve plexus density in HSK as an adjunct to improving monitoring of disease activity and damage.

The Role Of Femtosecond Lasers In Improving Outcomes In Corneal and Cataract Surgery

Geraint has secured travelling fellowships from the Royal College of Ophthalmologists and the Eleanor Peel foundation to study the application of femtosecond laser platforms in corneal and cataract surgery at SERI and SNEC. He is currently working with low energy, high repetition femtosecond laser systems to determine the effects of liquid optic interfaces on intra-ocular pressure, wound construction, capsulotomy and fragmentation and corneal opacification in cataract surgery. Furthermore he is determining the efficacy and safety profile of small incision lenticule extraction (SMILE) and LASIK combined with collagen cross-linking in animal models.

Other activities

  • Peer reviewer for a range of ophthalmic and medical journals

Publications

Journal articles

Williams GP, Pachnio A, Long H, Rauz S and Curnow SJ. Cytokine Production and Antigen Recognition by Human Mucosal Homing Conjunctival Effector Memory CD8+ T cells. Investigative Ophthalmology and Visual Science 2014 Nov 14 doi:10.1167/iovs.14-15133 [Epub ahead of print]

Cottrell P, Ahmed S, James C, Hodson J, McDonnell P, Rauz S and Williams GP. Neuron J is a rapid and reliable open source tool for evaluating corneal nerve density in Herpes Simplex Keratitis. Investigative Ophthalmology and Visual Science 2014 55(11):7312-20

Khan IJ, Ghauri A-J, Hodson J, Cottrell P, Edmunds MR, Evans S, Williams GP, Rauz S. Defining the Limits of Normal Conjunctival Fornix Anatomy in a South Asian Population. Ophthalmology 2014121(2):492-7

Williams GP, Tomlins PJ, Denniston AKO, Southworth HS, Sreeknatham S, Curnow SJ and Rauz S. Elevation of conjunctival epithelial neutrophils in Ocular Stevens- Johnson Syndrome and Toxic Epidermal Necrolysis. IOVS 2013 54 (7) pp. 4578-4585.

Williams GP, Denniston AKO, Oswal KS, Tomlins PJ, Barry RJ, Rauz S and Curnow SJ. ‘The dominant human conjunctival epithelial CD8αβ+ T cell population is maintained with age but the number of CD4+ T cells increases’. Age 2012 34(6):1517-1528

Radford C, Rauz S, Williams GP, Saw VP and Dart JKD. ‘Incidence, Presenting Features and Diagnosis of Cicatrising Conjunctivitis in the United Kingdom’. Eye 2012 26 (9) pp. 1199-208

Williams GP, Radford C, Nightingale P, Dart JKD and Rauz S. ‘Referral and Disease Patterns of Ocular Mucous Membrane Pemphigoid Patients at Two Major United Kingdom Tertiary Referral Hospitals’. Eye 2011 Sep;25(9):1207-18.

Williams GP, Saw VP, Saeed T, Evans ST, Cottrell P, Curnow SJ, Nightingale P, Rauz S. ‘Validation of a Fornix Depth Measurer - A Putative Tool for the Assessment of Progressive Cicatrising Conjunctivitis’. British Journal of Ophthalmology 2011 Jun;95(6):842-7.

Book chapter

Ocular Surface Disorders (Editors Benitez-del-Castillo JM and Lemp M). Chapter 12: Sjögren’s Syndrome and Related Conditions. Rauz S, Williams GP and Saw VP. JP Medical 2013.

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