Four riders enter a 50 mile cycle ride on one bike for charity…..

This isn’t the start of a joke—it’s a group of friends who are riding in the Liverpool Chester Liverpool (LCL) Bike Ride on a quad tandem (4 person bike) to raise money to fund research into eye disease. 

The team, aptly named ‘The Quad Squad’, consists of 2 ophthalmic surgeons from St Paul’s Eye Unit in Liverpool, and two fellow cyclists, and will be raising funds for St Paul’s Research Foundation – a charity that funds pioneering research to prevent sight loss.

The quad tandem, called Lucy, is from Michigan, USA, and arrived in Liverpool via friends ofCyclists with their Quad Tandem, Lucy consultant ophthalmologist, Nick Beare, who he worked with in Malawi whilst carrying out research into cerebral malaria – a disease that kills 400,000 people each year, 90% of whom are children in Africa.

The riders on a quad tandem sit in a line, like a tandem with 2 more riders.  The front cyclist controls the brakes, steering and gears and the other three peddle, provide the power and wave to all the turned heads. The Quad Squad had their first practice session yesterday, a point which Nick regards with some trepidation.

“We’ve had the first go with Lucy and it was great fun. Starting and stopping takes someNick (l) with fellow cyclists Henry, Paul and Reena coordination and good communication. As front man I get to shout all the commands, but it also means I have to really concentrate on what is coming on the road ahead – we cannot stop suddenly or nip round any obstacles. Turning is strange because the centre of gravity is behind me, like being at the very front of a double decker bus. I have to remember we are a long vehicle and drive accordingly! However people can’t help but stare and smile at a quad tandem. We got so many thumbs up and shouts of encouragement. That is going to really help on the LCL 50 miler. 

“Apparently, on a downward slope we can easily get up to 30 mph, so that will take a lot of trust and confidence of all the riders.  It will also make for a very interesting start as we enter the Mersey Tunnel. It is only when you ride through the tunnel that you realise how steep it is and going at those speeds without suspension will be challenging.”

Nick is raising funds for St Paul’s Research Foundation, a charity that has supported his work.

“St Paul’s Research Foundation is an important charity as it often pump-primes the early stages of research – the idea or theory that needs to be proved before applying for large research grants.  When I first travelled to Malawi it was to look at the changes at the back of the eyes of children affected by cerebral malaria. We proved that we could give an accurate diagnosis of cerebral malaria by looking at the distinctive features on the retina so that treatment could be given with much greater accuracy and confidence, and ultimately save lives. This was a huge breakthrough in our fight against this disease.

“Whilst working out there we also supported the establishment of a training programmeNick caring for poorly children in Malawi for ophthalmologists, and increased the number of ophthalmologists working in Malawi.

“This initial pump-priming has now enabled us to extend our work.  Cerebral malaria kills because of the swelling in the brain. New evidence has shown that we can determine the severity of the swelling in the brain by looking at the optic nerve at the back of the eye. 

“In the UK, if a child is affected by swelling of the brain we can use a MRI scanner to determine the causes of the swelling, however, this piece of equipment is expensive and not available in most of Africa.  

“We have started to look at the swelling of the optic nerve by using a piece of equipment called an OCT.  An OCT enables us to take a scan of the back of the eye. The OCTs we use in St Paul’s cost up to £170,000, however, the one we have been using in Malawi costs £70,000, which is still very expensive for many African countries.

“We want to develop and build a new OCT that will cost between £5,000 and £10,000. Also, because there is a shortage of ophthalmologists in many Africa countries, it is still difficult for a non-medical person to determine the severity of the swelling in the brain by looking at the optic nerve. To overcome this problem, we aim to develop artificial intelligence to carry out this function and build it into the camera so that a diagnosis can be given instantly.

“At St Paul’s, and with our colleagues in the Department of Eye and Vision Science, we have the knowledge and experience to be able to do this.  We are already working with the Dept of Electrical Engineering and colleagues in China to develop a camera and artificial intelligence for diabetic retinopathy – a sight threatening disease that affects 120 million Chinese people – that is twice the size of the whole UK population.”     

The LCL Bike Ride is an iconic event and has been a highlight in many cycling enthusiasts’ calendars for 28 years and this year it is being held on Sunday 4th July 2021. Nick is urging people to sign up and raise money for St Paul’s Research Foundation. 

“So much has been achieved from the support of the Foundation, not just with my work but it really has been crucial for many other ophthalmic research projects undertaken in Liverpool.  The Foundation created Liverpool’s first academic unit of vision science in 1992, and now we have more ophthalmic professors in the UK than anywhere else outside of London.”

To sign up for the LCL Bike Ride and be a part of #TeamStPauls visit the official website or contact St Paul’s Research Foundation on 0151 706 4291 or email

You can also sponsor “The Quad Squad” by clicking here.

For more information on St Paul’s Research Foundation’s work, please click here.

St Paul's quad tandem