Register your support as a member Member Registration Please use this form to register as a member of the Eye and Face Network. Once registered, there are a few other fields (such as profession and subspecialty) you will be able to complete at the next stage. Name * First Last Name * Last Email Address – This will be your username for logging in * Enter Email, this will be used as your username to log into this website. Confirm Email Address – This will be your username for logging in * Confirm Email Password * Choose your password to allow you to log into this website. Confirm Password * Confirm Password Institution (main place of work, or affiliation) Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Côte d'Ivoire Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthelemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Professional organisation/Society name * Of which recognized international or national medical society are you already a member (eg ASOPRS, ESCRS)? Please state one. This data will be used to validate your application to the Network. Professional organisation/Society website * Profession * Doctor Nurse Allied health professional IT Manager Logistics Financier Philanthropist Entrepreneur Other Profession Qualifications / Postnomials (e.g., MD, FRCOphth, etc) Specialty Dentistry Dermatology ENT Haematology Head and Neck Maxillofacial Neurology Neurosurgeon Oncology Ophthalmology Plastic surgery Radiology Other Specialty My chief areas of ophthalmic expertise include (tick one or more): * Anterior segment Cataract and refractive surgery General ophthalmology Glaucoma Histopathology Immunosuppression Medical ophthalmology Neuro-ophthalmology Ocular imaging Ocular inflammation Ocular injury Ocular oncology Oculoplastics: Eyelid Oculoplastics: Socket Oculoplastics: Lacrimal Oculoplastics: Orbit Paediatric ophthalmology Retina: Surgical Retina: Medical Strabismus: Adult Strabismus: Paediatric OtherOther Years of post-Fellowship practice 0 0-5 6-10 10+ Join virtual group * Yes No Would you be prepared to join a virtual group in your region/time zone to provide advice (related to your specialty) to colleagues dealing with patients injured in conflicts and catastrophes? You can change this decision at anytime by ticking/unticking this box Title Your local timezone -12:00 (GMT -12:00) Eniwetok, Kwajalein -11:00 (GMT -11:00) Midway Island, Samoa -10:00 (GMT -10:00) Hawaii -09:50 (GMT -9:30) Taiohae -09:00 (GMT -9:00) Alaska -08:00 (GMT -8:00) Pacific Time (US & Canada) -07:00 (GMT -7:00) Mountain Time (US & Canada) -06:00 (GMT -6:00) Central Time (US & Canada), Mexico City -05:00 (GMT -5:00) Eastern Time (US & Canada), Bogota, Lima -04:50 (GMT -4:30) Caracas -04:00 (GMT -4:00) Atlantic Time (Canada), Caracas, La Paz -03:50 (GMT -3:30) Newfoundland -03:00 (GMT -3:00) Brazil, Buenos Aires, Georgetown -02:00 (GMT -2:00) Mid-Atlantic -01:00 (GMT -1:00) Azores, Cape Verde Islands +00:00 (GMT) Western Europe Time, London, Lisbon, Casablanca +01:00 (GMT +1:00) Brussels, Copenhagen, Madrid, Paris +02:00 (GMT +2:00) Kaliningrad, South Africa +03:00 (GMT +3:00) Baghdad, Riyadh, Moscow, St. Petersburg +03:50 (GMT +3:30) Tehran +04:00 (GMT +4:00) Abu Dhabi, Muscat, Baku, Tbilisi +04:50 (GMT +4:30) Kabul +05:00 (GMT +5:00) Ekaterinburg, Islamabad, Karachi, Tashkent +05:50 (GMT +5:30) Bombay, Calcutta, Madras, New Delhi +05:75 (GMT +5:45) Kathmandu, Pokhara +06:00 (GMT +6:00) Almaty, Dhaka, Colombo +06:50 (GMT +6:30) Yangon, Mandalay +07:00 (GMT +7:00) Bangkok, Hanoi, Jakarta +08:00 (GMT +8:00) Beijing, Perth, Singapore, Hong Kong +08:75 (GMT +8:45) Eucla +09:00 (GMT +9:00) Tokyo, Seoul, Osaka, Sapporo, Yakutsk +09:50 (GMT +9:30) Adelaide, Darwin +10:00 (GMT +10:00) Eastern Australia, Guam, Vladivostok +10:50 (GMT +10:30) Lord Howe Island +11:00 (GMT +11:00) Magadan, Solomon Islands, New Caledonia +11:50 (GMT +11:30) Norfolk Island +12:00 (GMT +12:00) Auckland, Wellington, Fiji, Kamchatka +12:75 (GMT +12:45) Chatham Islands +13:00 (GMT +13:00) Apia, Nukualofa +14:00 (GMT +14:00) Line Islands, Tokelau Telephone Please include country code, eg +44 Opt-in permissions Once my application is validated, I agree to share my details with other validated professionals on the Network (optional, you change this at any time) I am willing to be contacted directly by another Member on the Network to discuss clinical case(s) as required WhatsApp Telephone Email All reCAPTCHA If you are human, leave this field blank. Register After submitting this form your details will be validated before activating your account.