# Insight: A Multi-Modal Diagnostic Pipeline using LLMs for Ocular Surface Disease Diagnosis

arXiv: https://arxiv.org/abs/2410.00292 · HTML: https://mlsanity.com/paper/2410.00292/

## Key facts

- Cited by 6 papers in the map (data through 14 Oct 2026).
- Builds on 9 of its 33 references that are in the map.
- First posted on arXiv 1 Oct 2024.

## Builds on (most cited first, 9 of 9)

- [Llama 2: Open Foundation and Fine-Tuned Chat Models](https://mlsanity.com/paper/2307.09288/) (2023)
- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [MiniGPT-4: Enhancing Vision-Language Understanding with Advanced Large Language Models](https://mlsanity.com/paper/2304.10592/) (2023)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [Eyes Wide Shut? Exploring the Visual Shortcomings of Multimodal LLMs](https://mlsanity.com/paper/2401.06209/) (2024)
- [MedAlpaca -- An Open-Source Collection of Medical Conversational AI Models and Training Data](https://mlsanity.com/paper/2304.08247/) (2023)
- [LLM-grounded Diffusion: Enhancing Prompt Understanding of Text-to-Image Diffusion Models with Large Language Models](https://mlsanity.com/paper/2305.13655/) (2023)
- [Semantic Instance Segmentation with a Discriminative Loss Function](https://mlsanity.com/paper/1708.02551/) (2017)
- [M-FLAG: Medical Vision-Language Pre-training with Frozen Language Models and Latent Space Geometry Optimization](https://mlsanity.com/paper/2307.08347/) (2023)

## Built on by (most cited first, 6 of 6)

- [Taming Vision-Language Models for Medical Image Analysis: A Comprehensive Review](https://mlsanity.com/paper/2506.18378/) (2025)
- [Region-Aware Multimodal Large Language Model via SlowFast Tokenization and Pseudo-Mask Guidance for 3D CT Report Generation](https://mlsanity.com/paper/2506.23102/) (2025)
- [FunBench: Benchmarking Fundus Reading Skills of MLLMs](https://mlsanity.com/paper/2503.00901/) (2025)
- [AGIR: Assessing 3D Gait Impairment with Reasoning based on LLMs](https://mlsanity.com/paper/2503.18141/) (2025)
- [CRAFT: Causal Responsibility and Failure Tracing in Medical Vision Language Models](https://mlsanity.com/paper/2609.38810/) (2026)
- [IRIS: An Intelligent Vision-Language System for Ocular Surface Diseases via Topic Tree and Scene-Driven VQA Generation](https://mlsanity.com/paper/2607.04344/) (2026)

## Abstract (arXiv)

Accurate diagnosis of ocular surface diseases is critical in optometry and ophthalmology, which hinge on integrating clinical data sources (e.g., meibography imaging and clinical metadata). Traditional human assessments lack precision in quantifying clinical observations, while current machine-based methods often treat diagnoses as multi-class classification problems, limiting the diagnoses to a predefined closed-set of curated answers without reasoning the clinical relevance of each variable to the diagnosis. To tackle these challenges, we introduce an innovative multi-modal diagnostic pipeline (MDPipe) by employing large language models (LLMs) for ocular surface disease diagnosis. We first employ a visual translator to interpret meibography images by converting them into quantifiable morphology data, facilitating their integration with clinical metadata and enabling the communication of nuanced medical insight to LLMs. To further advance this communication, we introduce a LLM-based summarizer to contextualize the insight from the combined morphology and clinical metadata, and generate clinical report summaries. Finally, we refine the LLMs' reasoning ability with domain-specific insight from real-life clinician diagnoses. Our evaluation across diverse ocular surface disease diagnosis benchmarks demonstrates that MDPipe outperforms existing standards, including GPT-4, and provides clinically sound rationales for diagnoses.