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Emerging Vision Scientist Program Application

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First Name*

Last Name*

Institution/School*

Title*

Email Address*

Cell Phone*

Home Address*

City*

State*

Zip Code*

Gender*

US Residency Status (This does not impact eligibility.)*

Degree(s)*

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OD

PhD

MD

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BOptom

BSc

MScOptom

Other

Race/Ethnicity*

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Area(s) of Expertise*

Select between 1 and 5 choices.

Age-Related Macular Degeneration (AMD)

Amblyopia (Lazy Eye)

Artificial Intelligence

Anophthalmia & Microphthalmia

Astigmatism

Autoimmune Ocular Diseases

Behcet's Disease

Bietti's Crystalline Dystrophy

Big Data

Biomaterials

Blepharitis

Blepharospasm

Cataracts

Central Retinal Vein Occlusion (CRVO)

Cerebral Visual Impairment (CVI)

Charles Bonnet Syndrome (CBS)

Clinical Research

Coloboma

Color Blindness

Conjunctivitis (Pink Eye)

Convergence Insufficiency

Corneal Conditions

Diabetic Retinopathy

Dry Eye

Floaters

Fuchs’ Dystrophy

Genetics

Gene Therapy & Gene Editing

Glaucoma

Graves' Eye Disease

Idiopathic Intracranial Hypertension

Imaging

Infectious Eye Diseases

Inherited Retinal Diseases (IRDs)

Keratoconus

Low Vision

Macular Edema

Macular Hole

Macular Pucker

Myopia (Nearsightedness)

Neuro-ophthalmology & Visual Neuroscience

Ocular Devices

Ocular Histoplasmosis Syndrome (OHS)

Ocular Oncology

Ocular Pharmacology / Drug Delivery

Ocular Surface Disease

Optic Nerve Disorders

Presbyopia

Pediatric Ophthalmology

Posterior Vitreous Detachment (PVD)

Public Health

Refractive Errors

Regenerative Medicine

Retinitis Pigmentosa

Retinopathy of Prematurity

Retinal Vascular Diseases

Strabismus

Thyroid Eye Disease

Traumatic Eye Injury / Ocular Trauma

Usher Syndrome

Uveitis

Other

What is the economic/societal impact of your research*

A brief high-level description

Details of research project to be presented*

A brief high-level description

Please attach your CV/Resume

Please ensure file name includes your name

Max. file size: 50 MB.

Please attach a headshot

This will be used in our poster reception dossier

Max. file size: 50 MB.

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Alliance for Vision Research is the brand name of the Alliance for Eye and Vision Research, a 501(c)(3) nonprofit. It is affiliated with the National Alliance for Eye and Vision Research, a separate 501(c)(4) organization conducting advocacy activities. Designed, Built, and Managed by Fifty and Fifty