1.2 This strategy has reinforced and extended core research activities and resources and is supported by a robust infrastructure and research governance plan based on high standards of information and performance measurement against a wide range of criteria including the 25 standards within the Research Governance Implementation Plan (see Attachment 3).

1.3 In order to ensure relevance and importance to the NHS and improvements in eye healthcare we have based our programmes around evidence based guidelines. Guidelines are based on systematic reviews and critical appraisal of the current scientific literature and can be graded according to the strength of the supporting evidence - for instance, randomised controlled trials (RCTs) provide more robust evidence than observational studies. The Knowledge Cycle identified in 'Research for a First Class Service' shows the relationship between research, policy and practice and how all those who use and work in the NHS can help to ensure that research is relevant to, and impacts upon, health and healthcare. (see Attachment 1) It is for these reasons that we have used the concept of a clinical guideline / pathway of care to describe programmes of research activity. As far as possible and where appropriate we have organised our programmes of activity to reflect the headings of the Royal College of Ophthalmologists National Research Strategy. (see Attachment 2)

1.4 The Royal College of Ophthalmologists sought the views of researchers into eye disease (including scientists and clinicians) and patients, for the major problems affecting the specialty and asked them to prioritise research areas for the next five years. The areas covered are retinal diseases, cataract, glaucoma, cornea and external eye disease, ocular adnexal disease, neuro-ophthalmology, the specialised area of visual rehabilitation, paediatric ophthalmology, squint and amblyopia. Each section considers a broad spectrum of activity including laboratory, clinical and health services research as appropriate to a clinical pathway as described above. Each section also follows the principle that clinical problems are best addressed by a collaborative combination of laboratory and clinical research, designed to address specific clinical problems. Such collaboration will allow a more rapid transfer of basic science to clinical practice with a clear audit trail linking one to the other. The outcomes of any research endeavour need to be looked at in terms of its contribution to the evidence base and will be dependent upon dissemination of results throughout the community in such a way as to improve public awareness and eye health. Each chapter concludes with a set of research priorities.

1.5 Within the structure of this ophthalmic research strategy and where possible, the Trust
has considered programmes of research activity relevant to specific clinical guidelines under the following headings:

a) Genetics, genotyping and risk factors,
b) Prevention and surveillance,
c) Symptoms, presentation and referral,
d) Phenotyping, information and communication,
e) Diagnosis, investigations and pathology,
f) Clinical Interventions - surgery, medical, radiological,
g) Follow-up,
h) Nursing, community care, rehabilitation
i) Psychosocial aspects.

The benefits of this approach are:

· It allows analysis of the knowledge gaps, definition and prioritisation of the relevant research effort and corresponding funding for different stages of health care delivery

· It facilitates the development of networks and collaborations and avoids duplication of effort

· It presents the opportunity to consider programmes of research informing prevention and treatment of specific eye diseases.