UCL Institute of Ophthalmology

Prof Paul Foster

Prof Paul Foster

Professor of Ophthalmic Epidemiology & Glaucoma Studies

Institute of Ophthalmology

Faculty of Brain Sciences

Joined UCL
1st Nov 2003

Research summary

A long term focus of my research career has been directed at the clinical characteristics, prevention and treatment of primary angle-closure glaucoma (PACG), with major research studies in Mongolia, Singapore, Bangladesh, Thailand, China and the UK. This research has culminated in authorship of over 100 research publications including: 

  • Definition and classification of glaucoma in epidemiological research (Br J Opthalmol 2002) - one of the most highly cited papers of all time in eye and vision science, which defined modern classification of PACG
  • Genome Wide Association Analysis Identifies 3 New Susceptibility Loci for Primary Angle-Closure Glaucoma (Nature Genetics 2012)
  • Genome Wide Association Study Identifies Five New Susceptibility Loci for Primary Angle-Closure Glaucoma (Nature Genetics 2016)
  • Effectiveness of Early Lens Extraction in Treatment of Primary Angle-closure Glaucoma - (Lancet 2016) - A major randomised controlled trial which identifies lens extraction as the optimal initial treatment for people with PACG
  • Laser Peripheral Iridotomy for the Prevention of Primary Angle-closure Glaucoma (Lancet 2019) - This trial identifies a small benefit for prophylactic laser iridotomy in people at risk of angle-closure, but suggests a poor cost effectiveness, on the basis of low rates of new disease

I have also pursued a broader study of the frequency, causes and diagnosis and management of glaucoma, with major research milestones including:
  • Glaucoma and Intraocular Pressure in the EPIC Norfolk Eye Study: A Cross Sectional Study (BMJ 2017)
  • Genome Wide Analysis Identifies 68 New Loci Associated with Intraocular Pressure and Improves Risk Prediction for Primary Open Angle Glaucoma (Nature Genetics 2018)

These latter two publications were developed from two major cohort studies on which I was lead investigator - The EPIC Norfolk Eye Study (EPIC Eye Study cohort profile - BMJ Open 2013), and The UK Biobank Eye and Vision Study (UKBB Eye Study cohort profile - BMJ Open 2019). These have become major research resources used by other investigators and research consortia. 

Parallels between glaucoma and other chronic neurodegenerative conditions such as Alzheimer's Disease have led to research using UK Biobank data to explore the relationship between retinal neuroanatomy and early cognitive decline:

  • The association of Retinal Nerve Fibre Layer Thinning with Current and Future Cognitive Decline (JAMA Neurology 2018)

Teaching summary

I teach on MSc Ophthalmology, MSc Optometry and MSc Biology of Vision courses, and lead module 8 - Therapeutics for the Anterior Segment of the Eye on the MSc Ophthalmology course (2012 to 2019). I am leading a comprehensive redesign of this module, revising the focus from anterior segment of the eye to a disease specific focus on glaucoma. I teach on FRCOphth final exam revision course and also teach residents staff at Moorfields Eye Hospital NHS Foundation Trust. I teach on Royal College of Ophthalmologists courses around the UK, as well as teaching at UK and International conferences. 

I am external examiner for the BMBS year 5 students at Exeter University School of Medicine. 


University College London
Doctorate, Doctor of Philosophy | 1995
University of Nottingham
Doctorate, Bachelor of Medicine/Bachelor of Surgery | 1989
University of Nottingham
Doctorate, Bachelor of Medical Science | 1987