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Management of risk in eye cancer presentation and referral

  • Full or part time
  • Application Deadline
    Sunday, April 12, 2020
  • Competition Funded PhD Project (European/UK Students Only)
    Competition Funded PhD Project (European/UK Students Only)

Project Description


Professor John G. Lawrenson
Professor Roger Buckley
Mr Konstantinos Balaskas

More Information

Deadline: 12 April 2020
Interview: 29 April 2020
Duration: 3 years, commencing October 2020
Stipend: £17,803

NIHR ARC North Thames

NIHR ARC North Thames is a research partnership committed to identifying the health and care problems that most concern everyone in our region and beyond, designing innovative research in response to those needs and then quickly putting the findings into practice. Led by Professor Rosalind Raine (UCL), the ARC is a collaboration of 50+ partners, including leading universities, NHS trusts, local authorities, clinical commissioning groups, UCLPartners, industry and organisations representing patients and the public. The following studentship is available in the innovation and implementation research theme.

Project Description

Choroidal naevus (similar to a mole on the skin) is a common benign pigmented lesion of the choroid, the nutritive layer that lies under the retina at the back of the eye. Since the lesion cannot be seen from the outside and is usually asymptomatic, it is typically identified as an incidental finding during a routine sight test. By contrast, choroidal melanoma is a rare life-threatening eye cancer, occurring in approximately six per million of the European-derived population. Failure to distinguish benign from malignant pigmented lesions can result in delays in care, suboptimal treatment outcomes and an increased risk of the tumour spreading to other parts of the body.
The conventional referral pathway for patients with pigmented choroidal lesions is via an urgent referral to an ophthalmologist (eye doctor) and then onto a retinal specialist or ocular oncologist (cancer specialist). There is a perception that the greater use of retinal imaging by community-based optometrists has led to an increased detection rate of ‘low risk’ pigmented lesions at the back of the eye and a corresponding increase in false positive referrals to specialist ocular oncology services. A number of strategies have been evaluated to address this problem including: the use of virtual service delivery models that rely on interpretation of retinal imaging results by non-medically trained graders or machine learning classifiers to distinguish between benign choroidal naevi and melanomas.
The College of Optometrists (the professional body for optometry in the UK) have also developed and implemented an evidence-based clinical guideline to enhance decision-making on the diagnosis, management and referral of pigmented choroidal lesions.

This mixed methods study will:
1. Investigate temporal referral trends for suspected ocular melanoma to regional ocular oncology services in the UK
2. Carry out a qualitative study to explore the views and experiences of healthcare professionals and patients in conventional and virtual eye cancer referral pathways
3. Identify the barriers and enablers to clinical guideline implementation and risk management by community optometrists
Project-specific skills and experience required
• Experience of qualitative research methods including semi-structured interviews and focus groups
• Familiarity with psychological theories of behaviour change e.g. Theoretical domains Framework
• Experience in quantitative methods and the statistical analysis of large datasets
• Good organisational skills and ability to work to deadlines


• Candidates should hold a Master’s in a relevant discipline (or complete their Master’s by September 2020) and have a minimum of a 2:1 or equivalent in their first degree.
• All applicants require excellent written and verbal communication skills and should be willing to work collaboratively in multi-disciplinary and multi-professional teams.
• Due to funding restrictions, applicants must be UK/EU nationals. Please see UK Council for International Student Affairs (UKCISA - for criteria.
• Applicants should preferably have knowledge of the UK health and care system.

How to apply

Your application should consist of:
• A CV (qualifications, work experience, publications, presentations and prizes) & contact details of two academic referees.
• A personal statement (300 words) describing your suitability for the proposed project including how your research experience, skills and interests relate to the topic.
• A 1-page proposal of how you would develop the PhD project that you are applying for.

For applications and enquiries, please email

Funding Notes

Duration: 3 years, commencing October 2020
Stipend: £17,803
Competitively Funded PhD Project (European/UK Students Only). Only one applicant for both ‘Management of risk in eye cancer presentation and referral’ and ‘Communication About Suicidality and Self-Harm in The Emergency Department’ will be appointed.

Details of the other project can be found here: View Website

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