Roger Buckley, formerly a prominent London ophthalmologist, has much experience in the teaching and regulation of optometry. His clinical and research interests include the ocular surface, comprising the cornea, the conjunctiva and the tear film, and contact lenses, the successful wearing of which depends upon compatibility with those structures. For some years he directed the country's premier contact lens service at Moorfields Eye Hospital. In addition, ocular allergy has long been a major interest. Roger Buckley 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.
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 Buckley 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 Buckley 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 DH'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 health care professionals.
Pullum KW and Buckley RJ (2007) Therapeutic and ocular surface indications for scleral contact lenses. The Ocular Surface, 5(1): 40-49.
Tullo AB, Buckley RJ, Kelly T, Head MW, Bennett P, Armitage WJ and Ironside JW. (2006) Transplantation of ocular tissue from a donor with sporadic Creutzfeldt-Jakob disease. Clin Experiment Ophthalmol, 34(7): 645-9.
Wickremasinghe SS, Smith GT, Pullum KW and Buckley RJ (2006) Acute hydrops in keratoconus masquerading as acute corneal transplant rejection. Cornea, 25(6): 739-41.
Pullum KW, Whiting MA, Buckley RJ (2005) Scleral contact lenses: the expanding role. Cornea 24(3):269-77.
Amin SZ, Smith L, Luthert PJ, Cheetham ME, Buckley RJ (2003) Minimising the risk of prion transmission by contact tonometry. Br J Ophthalmol, 87(11):1360-2.
Macalister GO and Buckley RJ (2002) The risk of transmission of variant Creutzfeldt-Jakob disease via contact lenses and ophthalmic devices. Cont Lens Anterior Eye, 25(3):104-36.
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