Large language models and their impact in ophthalmology.

The advent of generative artificial intelligence and large language models has ushered in transformative applications within medicine. Specifically in ophthalmology, large language models offer unique opportunities to revolutionise digital eye care, address clinical workflow inefficiencies, and enhance patient experiences across diverse global eye care landscapes. Yet alongside these prospects lie tangible and ethical challenges, encompassing data privacy, security, and the intricacies of embedding large language models into clinical routines. This Viewpoint highlights the promising applications of large language models in ophthalmology, while weighing up the practical and ethical barriers towards their real-world implementation. This Viewpoint seeks to stimulate broader discourse on the potential of large language models in ophthalmology and to galvanise both clinicians and researchers into tackling the prevailing challenges and optimising the benefits of large language models while curtailing the associated risks.
Competing Interests: Declaration of interests PvW declares financial interests as a cofounder of Enlighten Imaging, an early-stage medical technology start-up company devoted to hyperspectral retinal imaging and image analysis, including the development of artificial intelligence systems; research grant support from Roche and Bayer; and honoraria from Roche, Bayer, Novartis, and Mylan. RT declares consulting fees from Novartis, AbbVie, Allergan, Bayer, Alcon, Roche Genentech, Thea, Apellis, Iveric Bio, and Oculis; honoraria from Optic 2000; support for attending meetings from Novartis, AbbVie, Allergan, and Bayer; participation on advisory boards for Novartis, AbbVie, Allergan, Bayer, Apellis, Iveric Bio, Oculis, and Roche Genentech; a leadership role as the President Elect of Euretina; stock in Oculis; and equipment and materials from Zeiss. SS declares grants from Bayer and Boehringer Ingleheim; consulting fees from Roche, AbbVie, Apellis, Bayer, Biogen, Boehringer Ingelheim, Novartis, Janssen Pharmaceuticals, Optos, Ocular Therapeutix, and OcuTerra; support for attending meetings and travel from Bayer and Roche; participation on data safety monitoring boards or advisory boards for Novo Nordisk and Bayer; leadership in RCOphth, Macular Society, and Editor of EYE; stock in Eyebiotech; and equipment and materials from Boehringer Ingleheim. AYL reports grants to their affiliated institutions from Santen, Novartis, Carl Zeiss Meditec, Microsoft, NVIDIA, the National Institutes of Health (NIH; grant numbers NIH/NEI K23EY029246 and NIH OT2OD032644), Research to Prevent Blindness, and the Latham Vision Innovation Award. AYL reports consulting fees from USDA, Genentech, Verana Health, Johnson & Johnson, Gyroscope, Janssen Research and Development, and Regeneron; payment for lectures from Topcon; and payment from Alcon Research for various educational events and activities. ARR declares a grant from the Health and Medical Research Fund (grant number 19201991). CSL reports grants to their institution from the NIH (grant numbers NIH/NIA R01AG060942, NIH/NIA U19AG066567, and NIH OT2OD032644), Research to Prevent Blindness, and the Latham Vision Innovation Award; and consulting fees from Boehringer Ingelheim. TYW declares consulting fees from Aldropika Therapeutics, Bayer, Boehringer Ingelheim, Genentech, Iveric Bio, Novartis, Plano, Oxurion, Roche, Sanofi, and Shanghai Henlius; funding from the National Key R&D Program, China (grant number 2022YFC2502800); and being an inventor, patent holder, and cofounder of the start-up companies EyRiS and Visre. All other authors declare no competing interests.
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