Geraint Williams

Geraint Williams

Colleges, School and Institutes

Research interests

RESEARCH THEMES

 

Ocular Surface Immune Regulation in Health and Disease,

Improved Measurement of Clinical Disease Activity and Damage

 

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 is working 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 aiming to determine the frequency of peripheral T cells that recognise HSV immunodominant epitopes and 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. The aim is to undertake a Delphi process among UK 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. This builds on the work undertaken during his PhD, where he validated a Clinical Record Form (CRF) for measuring clinical scoring of cicatrising conjunctivitis.

 

Furthermore, Geraint is working to improve detection and classification of ocular surface infections such as HSK. He is currently evaluating the role of OSIC coupled with PCR analysis of Herpes Simplex Virus in those with clinical evidence of disease. This is being coupled with in vivo confocal microscopy to determine corneal changes including nerve plexus density in HSK as an adjunct to improving monitoring of disease activity.

Willingness to take PhD students

Yes

PhD projects

Geraint Williams specialises in cornea and external disease. His sub-specialist interest is 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.

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.

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