• 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

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 into 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 for best research. 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 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 and at SERI/SNEC, Singapore. He became a fellow of the Royal College of Ophthalmologists in 2013 and was appointed as a Consultant Ophthalmologist at Worcestershire Acute Hospitals NHS Trust and Honorary Consultant Ophthalmologist at University Hospitals Birmingham NHS Foundation Trust in 2016.

• Medicine and Surgery MBChB

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 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

Alongside 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.

• Peer reviewer for a range of ophthalmic and medical journals

Journal articles

Mathewson P and Williams GP (joint first authors), Hodson J, Watson S and Rauz S. An International Ocular Surface Disease Scoring System (OSDISS): Defining Activity and Damage by A Delphi Consultation. Ocular Surface 2017 Jan;15(1):97-111

Williams GP, Nightingale P, Southworth S, Denniston AK, Tomlins PJ, Turner S, Hamburger J, Bowman SJ, Curnow SJ and Rauz S (2016) Conjunctival neutrophils and progressive scarring in Ocular Mucous Membrane Pemphigoid. Invest Ophthalmol Vis Sci 57(13):5457-5469

Williams GP, George BL, Wong YR, Seah XY, Ang HP, Loke MKA, Tay SC and Mehta JS (2016) The effects of a low-energy, high frequency liquid optic interface system during femtosecond laser on lens capsulotomy. Scientific Reports 6:24352

Lugonja B, Yeo E, Milward M, Smith D, Dietrich T, Chapple ILC, Rauz S, Williams G, Barone F, de Pablo P, Buckley CD, Hamburger J, Richards A, Poveda-Gallego A, Scheel-Toellner D and Bowman S (2015) Periodontitis prevalence and serum antibody reactivity to periodontal bacteria in primary Sjögren’s syndrome: a pilot study. Journal of Clinical Peridontology 43(1):26-33

Williams GP, Ang HP, George BL, Liu YC, Peh G, Izquierdo L, Tan DT and Mehta JS (2015) Comparison of intraocular pressure changes with liquid or flat applanation interfaces in a femtosecond laser platform. Scientific Reports 5:14742 doi: 10.1038/srep14742

Williams GP, Pachnio A, Long HM, Rauz S and Curnow SJ (2014) Cytokine Production and Antigen Recognition by Human Mucosal Homing Conjunctival Effector Memory CD8+ T cells. Investigative Ophthalmology and Visual Science 55(12):8523-30

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

Khan IJ, Ghauri AJ, Hodson J, Edmunds MR, Cottrell P, Evans S, Williams GP and Rauz S (2014) Defining the Limits of Normal Conjunctival Fornix Anatomy in a South Asian Population. Ophthalmology 121(2):492-7

Williams GP, Tomlins PJ, Denniston AK, Southworth HS, Sreeknatham S, Curnow SJ and Rauz S (2013) Elevation of conjunctival epithelial neutrophils in Ocular Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis. Invest Ophthalmol Vis Sci 54(7):4578-85

Williams GP, Denniston AK, Oswal KS, Tomlins PJ, Barry RJ, Rauz S and Curnow SJ (2012) The dominant human conjunctival epithelial CD8αβ+ T cell population is maintained with age but the number of CD4+ T cells increases. Age (Dordr) 34(6):1517-28

Book chapters

Current Treatment Options for Fuchs Endothelial Dystrophy (Editor Cursiefen C). Chapter: DSAEK (not only) in Asian eyes: What glide to use? Optimized insertion techniques. Williams GP & Tan D. Springer 2017

Corneal Transplantation (Editor Jesper Hjortdal). Chapter 15b Technology: Femtosecond laser in keratoplasty. Williams GP and Mehta JS. Springer 2016

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