Please note: You can nominate as many people as you like, but please use the form only once for each person, as duplicate nominations will only be considered once.

 

Nominee's name *

 

Nominee’s job title and institution *

 

What is the most significant contribution the nominee has made to ophthalmology in the past 12 months? *

 

Key achievements in the past 12 months (describe as relevant):

Innovation (e.g., new devices, patents, tools)

 

Research (e.g., recent landmark papers, influential collaborations)

 

Teaching & Mentoring Progressing Practice (e.g., championing new procedures, implementing novel therapies)

 

Communication & Advocacy (e.g., innovative knowledge-sharing, outreach)

 

Humanitarianism (e.g., recent missions, global health initiatives)

 

YOUR name, title, and affiliation *

 

We embrace named entries, but please note that by completing this field you are providing The Ophthalmologist with permission to publish your name alongside your comments

If the nominee is chosen to appear on the list, can we contact you to put us in touch with the nominee to obtain information for the listing? If so, please provide your email address. *

 

If this email is new to Conexiant and you do not choose to subscribe to The Ophthalmologist below, your email address will only be used and retained for the purposes of the nominations until they are finalized in April 2026.

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