IMPORTANT :Avant d'exercer votre choix, veuillez,.Prendre connaissance des instructions situees au verso • Important : Before selecting please refer to instructions on reverse side

A. 0 Je desire assister a cette assemblee et demande une carte d'admission :dater et signer au bas du formulaire I I wish to attend the shareholders' meeting and request an admission card : date and sign at the bottom of the form.

B. J'utillse le formulaire de vote par correspondance ou par procuration cl-dessous, selon l'une des 3 possibilites offertes / I prefer to use the postal voting form or the proxy form as specified below.

Quelle que soit l'option choisie, noircir comme ceci la ou les cases correspondantes, dater et signer au bas du formulaire - Whichever option is used, shade box(es) like thisl date and sign at the bottom of the form

GENSIGHT BIOLOGICS

SA a conseil d'administration au capital de 488 511,33

Siege social : 74 rue du Faubourg Saint Antoine 75012 - PARIS

751 164 757 RCS PARIS

CADRE RESERVE A LA SOCIETE - FOR COMPANY'S USE ONLY

ldentifiant - Account

Voto simple

Single vote

ASSEMBLEE GENERALE MIXTE

Convoquee le 31 mai 2017 a 9 heures,

74 rue du Faubourg Saint-An'oine.

Nombre d'acllons

Number of shares

Nominatif

Rogistered

75012 Paris

[

[Porteur

Bearer

Voto double

Double vote

COMBINED GENERAL MEETING

To be held on May 31th. 2017 at 9:00 a.m.

Nombre de voile - Number of voting rights

74 rue du Faubourg Saint-Antoine, 75012 Paris

D JE DONNE POUYOIR,Al! PRESIDENT

DE L'ASSEMBLEE GENERALE

Cf. au verso (3)

I HEREBY GIVE MY PROXY TO THE CHAIRMAN OF THE GENERAL MEETING

See reverse (3}

O JE DONNE POUVOIR A :Ct. au verso (4)

I HEREBY APPOINT : see reverse (4)

M.,Mme OU Mle, Raison Sociale IMr, Mrs or Miss, Co,porate Name

Adresse I Address

O JE VOTE PAR CORRESPONDANCE / I VOTE BY POST

! Ct. au verso (2) - See reverse (2}

1-- ---1

8 Je vote OUI a touslos projots de resolutions presontes ou agrMs parle Surles projets de resolutions non agrees parle

:c Conseild'Administratlon oule Olrectolre oula Gerance, a !'EXCEPTION de Conseil d'Administration oule Oirectolre oula

ceux quo Jo slgnalo en nolrclssant comme ceci la case correspondante et Gerance, Je vote en nolrclssant commo ceci la pourlosquels je vote NON ou je m'absliens. case correspondant a mon choix.

o I vote YES all the draft resolutions approved by the Board of Directors On the draft resolutions not approved by the EXCEPT those Indicated by a shaded box - /Ike this I.for which I vote NO Board of Directors, I cast my vote by shading the or I abstain. box of my choice - like this I.

i1-- -+- --1

!

Oul I Non/No Out I Non/No

ATTENTION :s' l s'aglt de titres au porteur,les prosontos instructions ne seront valldes que si ellos sont directemont retournees a votre banque.

....

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1 2 3 4 5 6 7 8 9

0 0 0 0 0 0 0 0 0

Yes Abst/Abs Yes Abst/Abs

0

0

F

O

0

0

0

I

G

O

0

I A

CAUTION :

if it is about bearer securities, the present instructions will bo valid only if they are directly returned to your bank.

a

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(J}

Nom,prenom, adresse do l'actionnaire (les modifications de ces informations doivont etre adressaes et ne peuvont etre offoctucles a l'aide de ce formulaire). Ct au verso (1)

l'etabllssement conceme

j

u.

(J}

iii

x

w

10 11 12 13 14 15 16 17 18

0 0 0 0 0 0 0 0 0 I B

c

19 20 21 22 23 24 25 26 27

0 0 0 0 0 0 0 0 0 I

28 29 30 31 32 33 34 35 36

I H O 0

Surname. first name, address of tho shareholder (Change regarding this information have to bo notified to relevant Institution, no change can be made using this pro")' form}.See reverse (1}

w

0

i5 0 0 0 0 0 0 0 0 0 I D

w

a:

5 37 38 39 40 41 42 43 44 45

I J 00

:,

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0

0

0

0

0

0

0 0 0 0 0 0 0 0 0 I E

K O 0

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Sidesa,, ,e,Iden oeiits ou desresollJtions nouwles etlient pnismtesen assembJl,e I klcase imend7iencs or re.viesoW:.-.s srepropoood dmgthe

-Jedome p(llM)r w Pnsident defassartiltlog,!rhlEdede'enmon nom / apponthe C'l1anna-l the fP'rr,J moo/ir,;J II:>ldla,mybelwf...... O

.Je m'ab6tiens fabslenlion eq.iv.u a..,loQleccnlro)./ 1absmi> lh:>tn K>1W,g r,secp.,aert 11:> "'*'l'IJJ0

i= :. ,;,y5=po.nQ

Pour etre prise en consid6ration,toute formulo dolt parvenlr au plus tard :

In order to be considered, this completed fonn must be retumod at tho latost

I ,......-. I

sur 1- convocation I on 1st notnication sur 2'"' convocation I on 2nd notnteation

iila banque I to the bank 27mai 2017/ May 27th,2017

a la societe I to the company

••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

CONDITIONS D'UTILISATION DU FORMULAIRE

(1) GENEllAUTES

d '°J'' d, ' M •o,10 un,que r,&,o p,r a,OJ (c,:;., de UYnme«e oque ,.,,. [C!J',:,1 C".O

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o l'ode de ce loi"'lo,ie)

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(ortP. 225 77 o ,nee 3 du Coo.,"" (e

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oe (omrrr.e-1 r·,k rm I ',:""" 0 la ;()I,, f je · par CO""e!.pO,"'O:nce • • .l,e 00'/·ie pot.· , .IA-t1oe p 225-8

Ced, d, (O(T'r-"rc:la .t'f:.ion fron.;o se cl.! e doa.irnnt b.1 k•

(31 POUVOIR AU PRESIDENf DE l'ASSEM8lfE GENERAL£

Ar,cle l225 106 du Code de Cc,rc.,,•cce ,.,. o ti

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(41 POUVO!R A UNE PERSONNE DENOMMiE 3' E,1 e«,plo, r,:::, ,.,.1()(€1 ()(J P:.:' ,",,,,,r,n q,, lo :.en.1 i:k IC"« I 233-3

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(2) VOTE PAR CORRESPONDANCE

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FORM TERMS AND CONDITIONS

(11GENERAL INFORMATION

TI- , ,1 p. Ll 'O Ar , , 72570 do Code ooCur.,rr(.or.:,:? ·h,die.'N oc,.::,i u 1he s.1gn:::1.r., sho, -.:I

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(3) PROXY TO THE CHAIRMAN OF THE GENERAL MEETING Art.c L 225·1Coo_· ...,.-: (c...,ceie,t-o,:rl

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{21 POSTAL VOTING FORM

A:•, L :_> i. ;J7 ·=- Co:>. ., CO""rrll'fce

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  • foi rhe re,ol,t,on,nol ogreed by rhe Soord.yooc0,o.'e .,,,ol,1,on by re,olvhon by ,hodiog the appropcia•e bom Inca,e of ainedni, or ,-re>Olvt>on, dvnn9 the .horeholder meeoog. you o,e reque,!ed la choa,e be,-n 1h1ee po,,,b,! t,e, ipra,y la 1necha,rmon of the 9eoerol meeM9. ob,teloa rr,w,oned per ,on j,dr,,o!oi legc,I enl,ly), by ,hadi"9 the appcopnote bo,

;;nformotion indt.ded In th,s form is us.ed for o tOl'loo1tr Me. J h be11cu1on

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