Yr Athro Rachel North

Professor Rachel North

Professor

School of Optometry and Vision Sciences

Email:
north@cardiff.ac.uk
Telephone:
+44 (0)29 2087 5114
Fax:
+44 (0)29 2087 4859

Mae'r cynnwys hwn ar gael yn Saesneg yn unig.

My research interests include:

  • Diabetes and its ocular complications
  • Glaucoma
  • Vision and falls in the elderly
  • Retinal function in cystic fibrosis

My primary areas of research involve two of the major causes of blindness, diabetes mellitus and glaucoma. The early detection of both conditions is important for their management and improved prognosis, and we have been investigating the structural and functional changes using digital imaging, electrophysiological and psychophysical techniques.

1983PhD Ophthalmic Optics, University of Wales, Cardiff
1977Fellow of College of Optometrists
1976MSc Occupational Safety & Hygiene, University of Aston in Birmingham
1975BSc Hons Ophthalmic Optics, First Class, University of Aston in Birmingham

Honours and awards

  • Honorary Life Member of Vision Aid Overseas
  • Life Fellow of  College of Optometrists

Academic positions

2006 - 2012Deputy Head, School of Optometry & Vision Sciences, Cardiff University
2005 - presentProfessor, School of Optometry & Vision Sciences, Cardiff University
2000 - 2005Senior Lecturer, Dept of Optometry & Vision Sciences, Cardiff University.
1983 - 2000Lecturer, Dept of Optometry & Vision Sciences, Cardiff University.

Speaking engagements

2012NISCHR/ WSPCR Annual Conference – Falls and Balance Conference, Role of vision impairment in falls, Cardiff
2012City University, Monitoring and treatment of diabetes mellitus and its effect on retinopathy
2012City University, Diabetes – Review of Ocular complications of diabetes mellitus
2012CET/CPD Boots, Up to date with Diabetes, Bristol
2011Austrian Optical Society, Diabetic Retinopathy, Vienna
2011Role of Vision Aid Overseas in the correction of refractive error, World Congress of Refractive Errors, Durban
2010South African Optometric Association. Diabetes and its ocular complications, Durban
2010The Welsh Centre of Pharmacy Professional Education. Glaucoma – therapeutic update
2010Cumbria Local Optical Committee – Diabetes – sweet n' sour , Cumbria
2010College of Optometrists Annual meeting Research Key note. Diabetes Update - York April
2009North Ireland Optometric Education, Diabetic eye disease. Belfast
2009The Welsh Centre of Pharmacy Professional Education. Glaucoma – therapeutic update, Swansea
2009The Welsh Centre of Pharmacy Professional Education. Age related maculopathy -update, Swansea
2009Diabetes Update Conference, New developments in Diabetic Eye care, Cardiff

Committees and reviewing

  • School Board
  • Board member of Wales Optometric Post Graduate
  • Education Centre (WOPEC)
  • Member of Research Committee
  • Associate Director of Wales School of Primary Care Research.

External committees

2006 – 2013British Universities Colleges of Optometry Committee member
2011- 2012College of Optometrists Trustee
2009 – 2011College of Optometrist, Member of Research Committee
2011 - 2012College of Optometrists, Chair of Education Committee
2007 – presentOptometry Wales Council member
2012- presentNISCHR Primary Care Research Incentive Scheme Advisory group member
2011- presentDiabetes Research Network Wales (DRNW) Research Development Group – Diabetic Retinopathy
2007- presentWales Eye Health Week Strategy Committee member

Other

2007-2012Trustee Vision Aid Overseas (VAO)

Contributions to teaching include:

  • BSc programme: Module leader for Abnormal Ocular Conditions (OP3104), Occupational Vision module (OP3205) and also supervision in the Final year Binocular Vision Clinics
  • WOPEC Postgraduate Course: Module leader for Eyecare in Diabetes OPT22 and contributing lectures on Anterior ocular complications in diabetes mellitus and Visual functions in diabetes mellitus
  • Masters - research project supervision

My primary areas of research involve two of the major causes of blindness, diabetes mellitus and glaucoma. The early detection of both conditions is important for their management and improved prognosis, and we have been investigating the structural and functional changes using digital imaging, electrophysiological and psychophysical techniques.

The diabetes studies have been investigating the risk factors for the development of diabetic retinopathy in children and adults with Type 1 and Type 2 diabetes mellitus. We have found that patients with diabetes have functional changes prior to visible diabetic retinopathy and have investigated whether this functional loss detected in the early stages of eye disease is reversible. We found that oxygen inhalation has partially reversed functional loss in patients without diabetic retinopathy and we are currently studying patients with cystic fibrosis with and without diabetes.

The ability to detect structural changes to the retina have been evaluated using digital imaging techniques including scanning laser ophthalmoscopy, retinal thickness analyser, and stereoscopic fundus photography. We have also examined the choroidal structure using the 1050nm optical coherence tomography and found that the choroidal thickness is increased in diabetic patients. We found that the central choroid is thinner in all type 2 diabetic eyes regardless of disease stage, ie with or without clinically significant diabetic macular oedema.

The early detection of glaucoma has been studied by electrophysiological assessment of ganglion cell function, ocular blood flow and digital imaging of the optic nerve head. We have shown that electrophysiological measures are not only depressed prior to visual field loss in patients with glaucoma, but also in patients with ocular hypertension. This indicates that there may be dysfunction despite a normal structural appearance to the optic nerve head.

Methods for improving the clinical detection of glaucomatous optic neuropathy and its progression are being studied by using stereoscopic optic nerve head images.

In addition, we are using 1050nm optical coherence tomography (OCT) to create 3D volumetric datasets of the normal and glaucomatous optic nerve head in vivo in order to characterise optic nerve head parameters that have the potential to stage and/or predict glaucomatous optic neuropathy. In particular we are investigating the lamina cribrosa, in optic nerve heads at risk. We are also examining the relationship between the changes that take place in the optic nerve head comparison to those in the retina and choroid.

Funding

Funding has been awarded from: British Council for Prevention of Blindness, College of Optometrists, Diabetes UK, Welsh office for Research & Development, NERC, The Wellcome Trust, Raynauds & Scleroderma Association and The BUPA Foundation, Pfizer, Welsh Energy Research, Action Medical Research, Fight For Sight, UK & Eire Glaucoma Society & American Health Assistance Foundation.

  • RV North, J Kenkre, Alison Cooper, R Van Deursen, Survey of vision screening services provided for stroke patients in Wales, NISCHR/Wales School of Primary Care Research 2012, £8,375
  • Albon J, North RV, Morgan JE. The use of 1050nm OCT to identify changes of optic nerve head pathophysiology in glaucoma, College of Optometrists, 2011-2014. £52,688,
  • Albon J, North RV, Morgan JE, Disks at Risk. American Health Assistance Foundation, 2011-13. $100,000
  • Albon J, North RV, Drexler W, Morgan JE, , Optic nerve head changes in the progression of glaucomatous optic neuropathy using 1m OCT, Hirsch and Fight for Sight Award, 2010-11. £15,000
  • North RV, Albon J, Drexler W, Three dimensional imaging of the ageing and glaucomatous optic nerve head: risk factors for the development of open-angle glaucoma. UK&Eire Glaucoma Society and International Glaucoma Association, 2008-09. £20,000.

Research collaborators

  • Dr Julie Albon, Cardiff University
  • Professor James Morgan, Cardiff University
  • Dr Barbara Ryan, Cardiff University
  • Professor David Owens, Swansea University
  • Prof Joyce Kenkre, Glamorgan University
  • Dr Allison Cooper, OPAN, Swansea University
  • Thierry Zeyen, Leuven University, Belgium
  • Professor Wolfgang Drexler, University of Vienna, Austria

Currently have collaborations with School of Computer Science, School of Medicine, Dept of Primary Care and Public Health, Llandough Hospital, Dept of Physiotherapy, School of Healthcare Studies.

Current Postgraduate Students

2015 PhDBeth Flynn, The use of 1050nm OCT to identify changes of optic nerve head pathophysiology in glaucoma, College of Optometrists, 2011-2014.
2015 PhDAreej Okashah, Portable Electronic Low Vision Aids for people with visual impairment.
2014 PhDRachel Hiscox, The retina in Cystic Fibrosis.
2014 PhD  Alison Ng, The effects of cosmetics on the ocular surface and tear film.
2014 PhDDitipriya Mukhopadhyay, The effect of peripheral corneal thickness on the accuracy of applanation tonometry.
2014 PhD  Rebecca Thomas, Optimal time to next screen for diabetic retinopathy in screen negative persons with diabetes.

Previous Postgraduate Students

2013 MPhilStephen John "Comparison of two different methods of stereoscopic viewing and the effect of teaching on the assessment of the cup to disc ratio for glaucoma detection"
2012 PhDWalter Gutstein, "Measurement of Vision under conditions of contrast and luminance simulating those of real environments"
2012 PhDSamuel Heinz Dremmel, "Diagnostic aspects of structure and function in primary open angle glaucoma"
2012 PhDMizhanim Mohamad Shahimin, "Development and validation of a digital quantitative orthoptics workstation".
2010 PhDSaud Alanazi, "Investigation of the clinical factors affecting heterophoria & fixation disparity measurements".
2010 PhDMana Alanazi, "Studies of visual function and the effect of visual fatigue in adults with dyslexia"
2009 PhDKatharine Evans, "Cystic Fibrosis and the eye".
2007 PhDJennifer Cumiskey, "Electrophysiological studies of retinal function at low light levels in type 2 diabetes mellitus
2004 MPhilSarvenaz Malihi , "Investigation of retinal function in diabetes mellitus"
2004 PhDDominique Arlotte, "Investigation of Oscillatory Potentials in patients with diabetes mellitus".
2004 PhDAdrian Jones, "Investigation of primary open angle glaucoma and ocular hypertension by electrophysiological and digital imaging techniques".
2003 PhDNik Sheen, " Evaluation of digital retinal imaging in the diagnosis and management of glaucoma".
2002 PhDRhianon Perrott , "The significance of pulsatile ocular blood flow in the management of diabetic retinopathy".
2001 PhDZohreh Chiti,  "Electrophysiological investigation into the effect of oxygen inhalation on retinal function in Type II Diabetes Mellitus".
2001 PhDKatie Mortlock (Jenkins), "Neurophysiological examination of retinal function in patients with Type 1 Diabetes Mellitus".
1999  PhDZeki Ali, "The influence of the management of diabetes mellitus and its management upon visual functions"
1997 MPhilUna Whitcombe, "Clinical evaluation of ocular and visual functions of young patients with insulin dependent diabetes mellitus"
1995 MPhilDenise Banford, "Longitudinal study of visual functions in children with Type 1 diabetes mellitus.
1988 MPhilBeth Kelly   "Atropine occlusion in the treatment of strabismic amblyopia"