Consultant interview - Miss Winifred Nolan

What are your areas of expertise?

In my NHS and private practice I see and treat patients with newly diagnosed primary (open angle and angle closure) or secondary glaucoma (patients who have glaucoma secondary to other conditions e.g. uveitis, neovascular glaucoma, post-vitrectomy glaucoma, cornea related glaucoma). I have a complex surgical practice and perform trabeculectomy surgery, aqueous shunt, laser procedures and cataract surgery. I see and manage patients referred from optometrists, GPs and ophthalmology colleagues within Moorfields, the UK and from overseas. Many of the patients I see are referred for a second opinion on management of their glaucoma.

Are you involved in research projects?

I completed an MD thesis at the Institute of Ophthalmology which evaluated the role of screening and laser treatment to prevent primary angle closure glaucoma in Asia and went on to collaborate with colleagues in Singapore to evaluate anterior segment OCT in the diagnosis of angle closure.

I am an Associate Professor at the International Centre for Eye Health which is based at the London School of Hygiene and Tropical Medicine where I am working as part of an international glaucoma research team to develop a programme of research into prevention of glaucoma blindness in Sub-Saharan Africa.

Are you a teaching consultant?

We have an ongoing fellowship programme on the glaucoma service with UK and international fellows who come to Moorfields for subspecialist training in glaucoma. I supervise and teach fellows and junior doctors as well as optometrists who work in the clinics.

I developed online and resident training courses in glaucoma surgery for the Moorfields/ West African College of Surgeons surgical training centre in Accra, Ghana.

I teach regularly on the Masters in Ophthalmology for University College London and the Masters in Public Health for Eye Care at the London School of Hygiene and Tropical Medicine. I give regular lectures to optometrists attending courses at Moorfields.

Why do patients come to see you?

Patients come to see me for 2 reasons. Optometrists and GPs refer patients who they suspect may have glaucoma on routine site testing or due to a family history of the condition. I confirm if that is the diagnosis and offer treatment which may be eye drops or laser.

The second reason is that a patient may have an existing diagnosis of glaucoma or another eye condition which can lead to glaucoma. The patient or their Consultant may want a second opinion on the management of their glaucoma. These patients may require glaucoma surgery to lower their intraocular pressure and stabilise the glaucoma.

Why refer glaucoma patients to Moorfields Private?

Moorfields Private has the resources and expertise to manage any patient from those with low risk or suspected primary glaucoma to those with complex glaucoma and multiple eye problems. Diagnostic testing, laser and surgical facilities are all available on site to ensure a rapid assessment of patients and development of an appropriate management plan. Patients may require co-management between ophthalmologists with different sub-specialist expertise which is all readily available at Moorfields Private.