Professor Roger Buckley

Roger Buckley was one of the founders of VERI (originally the Vision and Eye Research Unit, VERU). He is an ophthalmologist (eye doctor) with extensive experience in clinical practice, research and teaching.

roger.buckley@aru.ac.uk

Background

Additionally, Roger has much experience in the teaching and regulation of optometry. He trained at Moorfields Eye Hospital, London, where he was appointed to the consultant staff in 1981; he also directed the Contact Lens Service there for many years, and remains an Honorary Consultant. He was appointed Professor of Ocular Medicine at City University London in 1997, and was able to transfer that Chair to Anglia Ruskin University in 2005.

Roger has held many positions of high professional responsibility and his advice is regularly sought by professional groups and the media. His lecturing experience, both at home and abroad, is extensive. His clinical and research interests include the ocular surface, comprising the cornea, the conjunctiva and the tear film. Ocular allergy has long been a major interest.

Research interests

• Tear film and ocular surface
• Ocular allergy
• Contact lens medicine including avoidance and management of corneal infection
• Corneal structure and function (especially endothelium)
• Corneal ectasia, keratoconus and related conditions
• Avoidance of disease transmission in clinical practice
• Development of clinical management guidelines for prescribing optometrists

Research activities

Cellular and Humoral Mechanisms of Ocular Damage in Allergic Conjunctival Disease
This was a programme of combined laboratory and clinical research carried out jointly between the Institute of Ophthalmology and Moorfields Eye Hospital. The work was coordinated by Prof Susan Lightman; Dr Virginia Calder provided the laboratory-based expertise and Roger Buckley contributed the clinical link. The work showed that different types of allergic eye disease involved different cell types and humoral mediators, paving the way for the development of more specific drug treatments. Several papers have been published.

Clinical Investigations into the Management of Allergic Eye Disease
Roger has carried out clinical research into the management of various allergic eye diseases, including the severe, sight-threatening varieties that can affect both children and adults. This has involved topically applied drugs, including mast cell stabilisers, antihistamines, steroids, an immunosuppressive agent and surgery.

Clinical Research into new forms of Contact Lenses, the Therapeutic Applications of Contact Lenses and new Contact Lens Wearing Modalities
The use of contact lenses of all types may assist in the management of ocular surface diseases. Particular emphasis has been laid on the use of modern scleral lenses in such management. Thanks to the development of gas-permeable scleral lenses it has been possible to propose continuous wear where this is clinically desirable.

Investigations into the Aetiology, Genetics, Associations and Clinical Management of Keratoconus
Keratoconus is a condition in which the cornea becomes thin and irregular, greatly compromising vision. It is managed with the aid of contact lenses of various types and in some cases with surgery. The condition is inheritable and continuing work at Moorfields Eye Hospital aims, by collecting blood specimens from families in which there are keratoconus sufferers, to identify the genetic profile of this condition. Earlier work at Moorfields has established the existence of associations with other collagen disorders, including hypermobility of the joints of the wrist and hand. New contact lens designs have been developed specifically for the fitting of the keratoconic cornea.

New Strategies for the Management of Tear Deficiency Syndromes
Roger has supervised a number of commercially funded clinical trials aimed at improving the management of tear deficiency, a condition that affects around 8% of middle-aged women. Fewer than 1% have Sjøgren's Syndrome, an immune condition for which immunosuppressive treatment may be helpful. Further work is needed in this area and in the related subject of natural tear conservation.

Strategies for the Avoidance of Disease Transmission in Ophthalmological and Optometric Practice
The Department of Health's unprecedented announcement in 1999 that trial contact lenses might transmit vCJD or other prion diseases provoked a flurry of research activity. Previous work having established that solutions of sodium hypochlorite were effective at denaturing prion protein led to the development of a protocol for the decontamination of trial contact lenses and ophthalmic devices, including tonometer prisms. Though subsequent research indicates that the initial scare was exaggerated, the general principles of avoidance of the transmission of disease through clinical procedures are now better appreciated. Work on the decontamination of surgical instruments and on the development of disposable instruments has taken place and is particularly relevant in the area of vitreo-retinal surgery.

In addition to the specific example quoted above, general cross-infection control needs to become better integrated into routine optometric and ophthalmic dispensing practice. Fuelled by the over-use of antibiotics for trivial infections and in the food chain, microbial drug resistance has become a major problem that needs to be addressed by all healthcare professionals.

Areas of research supervision

• The tear film in health and disease
• The effect of experimental environmental conditions on the surface of the eye
• The management of allergic eye disease

Anglia Ruskin University PhDs recently completed:

• Willshire C: Tear dynamics: tear osmolarity and reflex features of the lacrimal functional unit (awarded October 2018) (As first supervisor)
• Rolev K D: Evaluation of corneal endothelial cell therapy using an in vitro human model (awarded December 2017) (As internal examiner)

Teaching

At Moorfields Eye Hospital, Roger taught Senior House Officers, Registrars, Fellows and Visiting Fellows during the course of his out-patient and in-patient clinical duties. Many of them now hold consultant posts in this country (including Moorfields Eye Hospital) and overseas. Roger also taught visiting overseas doctors, medical students, optometrists, orthoptists and nurses.

At Anglia Ruskin University, Roger has lectured on ocular abnormality and disease to 3rd Year undergraduates, and on pharmacology and introductory topics to the 2nd year. Roger has also supervised 3rd year projects and dissertations, usually around three or four per year.

At City University, London, Roger lectures on the regular courses held for the training of prescribing optometrists.

At Imperial College, London, Roger contributes regularly to the MSc course in Allergy.

Roger has supervised numerous MSc projects and PhD theses and has acted as an external examiner in both areas.

Roger has acted as External Examiner to the optometry training courses of other universities (Glasgow Caledonian University, Scotland and the University of Ulster, Northern Ireland).

Qualifications

• BM, BCh (Bachelor of Medicine and Bachelor of Surgery), Oxford University
• MA, Oxford University
• PhD, Anglia Ruskin University
• FRCS (Fellowship of the Royal College of Surgeons, London)
• FRCOphth (Fellowship of the Royal College of Ophthalmologists, United Kingdom)
• Hon FCOptom (Honorary Fellowship of the College of Optometrists, United Kingdom)
• FBCLA (Fellow of the British Contact Lens Association)

Memberships, editorial boards

• Member, British Medical Association
• Fellow, Royal Society of Medicine
• Honorary Member, Medical Contact Lens and Ocular Surface Association (President, 1989-92)
• Member of the European Contact Lens Society of Ophthalmologists
• Former member, International Society for Contact Lens Research (Vice-President, 1993-95)
• Honorary Member, British Contact Lens Association; Chairman of Academic Committee 2009-2013; President 2003-4
• Member of the Committee on Dental and Surgical Materials, DHSS/DoH, 1982-94, and Chairman of its Sub-Committee on Ophthalmic Products, 1981-83
• Co-opted Member of the Committee on Safety of Medicines, DoH, 1994-96
• Member of Medicines Control Agency/Committee on Safety of Medicines Expert Advisory Panel, January 1996 to date
• Member, General Optical Council, representing the Royal College of Ophthalmologists, 1987-2007; Member of its Education, Professional Conduct and Contact Lens Committees; Chairman of Standards Committee
• Founder Member of Executive Committee, Allergy UK (formerly the British Allergy Foundation); currently Patron; Member, Health Advisory Panel (2010 to date)
• Former Member of the Contact Lens Sub-Committee of the British Standards Institution, representing the British Medical Association and the College of Ophthalmologists (1984-89)
• External Examiner, Department of Visual Sciences, Glasgow Caledonian University, 1995-97
• External Examiner, School of Biomedical Sciences, University of Ulster, 2006-2011
• President, Keratoconus Self-Help and Support Group (a patient-run organisation)
• Honorary Medical Adviser to the British National Formulary, 1991-2011
• Honorary Medical Officer, British Performing Arts Medicine Trust, 1989-2007
• Honorary Medical Adviser, Musicians' Benevolent Fund, 1983-2007
• Honorary Medical Officer, Royal Society of Musicians of Great Britain, 1989-2007
• Member, City University Medicines Support Unit Advisory Board, 2009 to date
• Member, Eyecare Trust Clinical Advisory Panel, 2011 to date

Research grants, consultancy, knowledge exchange

Editorial Boards and Peer Review
Member of International Editorial Board, formerly Journal of the British Contact Lens Association and now Contact Lens and Anterior Eye).
Reviewer for Cornea, British Journal of Ophthalmology, Eye, PLOS ONE, Paediatric Allergy and Immunology, Clinical and Experimental Optometry, Contact Lens and Anterior Eye, Ophthalmology.

Consultancy
College of Optometrists: Clinical Management Guideline Development, 2008 to date.

Selected recent publications

Gane J, Buckley R. Leukotriene Receptor Antagonists in Allergic Eye Disease: A Systematic Review and Meta-analysis. J Allergy Clin Immunol: In Practice 2013;1: 65-74.

Sanchez-Parra L, Pardhan S, Buckley RJ, Parker M, Bourne RRA.  Diurnal Intraocular Pressure and the Relationship with Swept-Source OCT-Derived Anterior Chamber Dimensions in Angle Closure: the IMPACT Study.  Invest Ophthalmol Vis Sci. 2015;56:2943–9.

Willshire, C., Buckley, R. Bron, A.  Standardising the Schirmer Test by Enclosing the Strip in a Waterproof Sheath.  Acta Ophthalmologica. 2015;[e-journal]93(S255)

Scadding GK, Kariyawasam HH, Scadding G, Mirakian R, Buckley RJ, Dixon T, Durham SR, Farooque S, Huber PAJ, Jones N, Leech S, Nasser SM, Powell R, Roberts G, Rotiroti G, Simpson A, Smith H, Clark AT.  BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (Revised Edition).  Clinical and Experimental Allergy. 2017;47:856-89.

Willshire C, Buckley RJ B, Bron AJ. Central Connections of the Lacrimal Functional Unit.  Cornea. 2017 Aug;36(8):898-907.

Willshire C, Buckley RJ, Bron AJ. Estimating basal tear osmolarity in normal and dry eye subjects. Contact Lens and Anterior Eye. 2018 Feb;41:34-46.

Buckley RJ.  Assessment and Management of Dry Eye Disease.  Eye. 2018 Feb;32:200-203.

Recent presentations and conferences

Roger Buckley (2017). Assessment and Management of Dry Eye Disease. Cambridge Ophthalmological Symposium. Cambridge, UK.

Roger Buckley (2018). 1. Avoidance and Management of Infective Keratitis and Conjunctivitis; 2. Ocular Allergy. Principles of Independent Prescribing Course, Module 2. City University, London UK.

Roger Buckley (2019). Allergic Eye Disease: Diagnosis and Management. PG Cert Allergy, Module 2. Imperial College, London UK.

Media experience

Numerous local radio, national radio and television appearances connected with medical or contact lens related news items, and phone-in programmes.