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REGISTRATION FORM DIRECTIONS Return this form with your payment by fax, mail or email as soon as possible. FROM THE SOUTH VIA I-95 Follow I-95 North to I-76 West (Schuylkill Expressway). Follow I-76 West to Exit 340B (Route 1 North—Roosevelt Boulevard). Follow Route 1 North and exit at Broad Street. Turn left onto Broad Street and drive 20 blocks. Bear right onto Route 611 North (Old York Road) and drive approximately 2 ½ miles. Turn left onto Route 73 West (Township Line Road). Turn left at first light onto Breyer Drive. Follow signs for Salus University’s campus and parking. SALUS UNIVERSITY Pennsylvania College of Optometry Office of International and Continuing Education 8360 Old York Road Elkins Park, PA 19027 T F E 215.780.1382 215.780.1325 [email protected] Registration will be processed on a first-come, first-served basis. Please register as soon as possible. Name Address City State Zip OE Tracker Number (find your OE Tracker number at www.arbo.org) State of Licensure PCO Alumnus License Number Yes EXHIBITORS OCULAR SURFACE DISEASE SYMPOSIUM FROM THE NORTH AND WEST VIA PENNSYLVANIA TURNPIKE Follow the Pennsylvania Turnpike to Exit 339 (Route 309 toward Fort Washington/Ambler) Follow Route 309 South to the Flourtown/Route 73 East/ Church Road exit Turn left onto Route 73 East/Church Road After about 3.5 miles, turn left onto Washington Lane/ Route 73 East Turn right onto Township Line Road/Route 73 East Turn right at first light onto Breyer Drive Follow signs for Salus University’s campus and parking. No Year Graduated Optometry School Phone Email (required for registration confirmation) SUNDAY FROM THE EAST VIA PENNSYLVANIA TURNPIKE Follow the Pennsylvania Turnpike to Exit 343 (Willow Grove—Route 611). Follow Route 611 South for 6 miles. Turn right onto Route 73 West (Township Line Road). Turn left at first light onto Breyer Drive. Follow signs for Salus University’s campus and parking. SEPTEMBER 20, 2015 8 Hours—COPE Approval Pending The registration fee is $195 per person. Check (payable to Salus University) Credit Card (circle one) Card Number VISA MasterCard 8360 Old York Road Elkins Park, PA 19027 salus.edu Expiration Date T Cardholder’s Name F E Room 300 South 8360 Old York Road Elkins Park, PA 215.780.1382 215.780.1325 [email protected] Signature THE FUTURE OF HEALTH SCIENCE SINCE 1919. salus.edu OCULAR SURFACE DISEASE is one of the most common conditions an optometrist encounters. This one-day course provides you with the most current knowledge and skills necessary for the best patient outcomes. Practitioners will present the latest information on the diagnosis of ocular surface disease, including new imaging techniques, tear osmolarity testing and the assessment of key immunologic biomarkers. They will also cover contemporary treatment modalities, such as thermal massage, amniotic membranes and the use of supplements. The course will include practical tips and strategies to integrating the diagnosis and treatment of ocular surface disease into your practice. SCHEDULE SUNDAY, SEPTEMBER 20, 2015 7:30 AM Registration and Continental Breakfast 8:00 AM Ocular Surface Disease Manifestations of Systemic Disease Alissa Coyne, OD, FAAO 9:40 AM Break 9:55 AM The Business Side of the Diagnosis and Management of Ocular Surface Disease James Deom, OD, MPH 11:35 AM Lunch LECTURERS REGISTRATION ALISSA COYNE, OD, FAAO JAMES LEWIS, MD Dr. Coyne graduated from Pennsylvania State University with a degree in biobehavioral health. She earned her doctor of optometry degree from the Pennsylvania College of Optometry at Salus University and completed a primary care residency at The Eye Institute of Salus University, where she is currently an assistant professor. Dr. Coyne has special interests in ocular disease, emergency eye care, and ocular pharmacology. She has lectured internationally and published on the subjects of herpes simplex keratitis and ocular allergies. Dr. Lewis is a board-certified ophthalmologist with fellowship training in cornea, external disease and anterior segment surgery. He has an active clinical practice in which he performs cataract, LASIK, corneal transplantation as well as minimally invasive glaucoma surgery. His research includes new techniques for the diagnosis and management of allergy and dry eye. He currently serves as director of cataract, LASIK and corneal surgery at The Eye Institute of Salus University. JAMES DEOM, OD, MPH Dr. Neal is chief of glaucoma at James Lewis, MD, PC in Elkins Park, Pennsylvania. After graduating from the Pennsylvania College of Optometry, he completed a cornea and contact lens residency at The Eye Institute of Salus University. He currently lectures at Salus University in the doctor of optometry degree program and the advanced studies program on the topics of anterior segment disease and cataract, LASIK and corneal surgery. BRETT NEAL, OD A graduate of Salus University Pennsylvania College of Optometry, Dr. Deom has lectured nationally and internationally on anterior segment disease, scleral lens care, and practice management. He is a staff optometrist at Hazleton Eye Specialists, Stroudsburg Eye Specialists and the Dry Eye Clinic of Northeastern Pennsylvania. Dr. Deom founded and is currently the medical director of the Scleral Lens Institute in Hazleton, Pennsylvania. He holds leadership roles in the POA, AOA, and Scleral Lens Society. MARCUS DEVLIN, OD Dr. Devlin is the clinical director at James Lewis, MD, PC in Elkins Park, Pennsylvania. He concentrates on cornea, cataract and refractive surgical management. A graduate of the Pennsylvania College of Optometry, he completed a residency in cornea and contact lens at The Eye Institute of Salus University. Dr. Devlin is adjunct faculty at Salus University, where he lectures on anterior segment and participates in the externship, advanced studies and residency programs. Fee: $195 per person This fee includes continuing education, continental breakfast, lunch and downloadable handouts. Capacity is limited. Registration is processed on a first-come, first-served basis: Email: [email protected] Tel: 215.780.1382 Fax: 215.780.1325 Confirmation of your registration will be sent by email— please provide your email address on the registration form. A $25 administrative fee will be charged for all cancellations. No refunds will be made after Friday, September 11, 2015. For more information, call Salus University at 215.780.1382 or email [email protected]. EXHIBITORS Allergan Bio-Tissue MiBo Medical Group Optovue Topcon Medical Systems, Inc. 12:35 PM Ocular Surface Disease: Latest Diagnostic Techniques HANDOUTS Download the handouts from our online course directory at ecampus.salus.edu. A user name and password will be provided with your registration confirmation. All handouts will be available by Monday, September 14, 2015. Marcus Devlin, OD; James Lewis, MD and Brett Neal, OD 2:15 PM Break 2:30 PM Ocular Surface Disease Management: A Comprehensive Approach Marcus Devlin, OD; James Lewis, MD and Brett Neal, OD 4:10 PM Closing OCULAR SURFACE DISEASE SYMPOSIUM SUNDAY SEPTEMBER 20, 2015 8 Hours—COPE Approval Pending Room 300 South Elkins Park, PA 19027