# OphCLIP: Hierarchical Retrieval-Augmented Learning for Ophthalmic Surgical Video-Language Pretraining

arXiv: https://arxiv.org/abs/2411.15421 · HTML: https://mlsanity.com/paper/2411.15421/

## Key facts

- Cited by 29 papers in the map (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 62 of its 85 references that are in the map.
- First posted on arXiv 23 Nov 2024.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)
- Retrieval-augmented generation / [Medical and biomedical RAG](https://mlsanity.com/rag/medical-and-biomedical-rag/)

## Builds on (most cited first, 30 of 62)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [Representation Learning with Contrastive Predictive Coding](https://mlsanity.com/paper/1807.03748/) (2018)
- [Robust Speech Recognition via Large-Scale Weak Supervision](https://mlsanity.com/paper/2212.04356/) (2022)
- [Exploring Simple Siamese Representation Learning](https://mlsanity.com/paper/2011.10566/) (2020)
- [Improving language models by retrieving from trillions of tokens](https://mlsanity.com/paper/2112.04426/) (2021)
- [CoCa: Contrastive Captioners are Image-Text Foundation Models](https://mlsanity.com/paper/2205.01917/) (2022)
- [Frozen in Time: A Joint Video and Image Encoder for End-to-End Retrieval](https://mlsanity.com/paper/2104.00650/) (2021)
- [HowTo100M: Learning a Text-Video Embedding by Watching Hundred Million Narrated Video Clips](https://mlsanity.com/paper/1906.03327/) (2019)
- [Dense-Captioning Events in Videos](https://mlsanity.com/paper/1705.00754/) (2017)
- [A-OKVQA: A Benchmark for Visual Question Answering using World Knowledge](https://mlsanity.com/paper/2206.01718/) (2022)
- [VideoBERT: A Joint Model for Video and Language Representation Learning](https://mlsanity.com/paper/1904.01766/) (2019)
- [In-Context Retrieval-Augmented Language Models](https://mlsanity.com/paper/2302.00083/) (2023)
- [Capabilities of GPT-4 on Medical Challenge Problems](https://mlsanity.com/paper/2303.13375/) (2023)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [Segment Everything Everywhere All at Once](https://mlsanity.com/paper/2304.06718/) (2023)
- [Image Segmentation Using Text and Image Prompts](https://mlsanity.com/paper/2112.10003/) (2021)
- [SLIP: Self-supervision meets Language-Image Pre-training](https://mlsanity.com/paper/2112.12750/) (2021)
- [Supervision Exists Everywhere: A Data Efficient Contrastive Language-Image Pre-training Paradigm](https://mlsanity.com/paper/2110.05208/) (2021)
- [Expanding Language-Image Pretrained Models for General Video Recognition](https://mlsanity.com/paper/2208.02816/) (2022)
- [Generalized Decoding for Pixel, Image, and Language](https://mlsanity.com/paper/2212.11270/) (2022)
- [Improving CLIP Training with Language Rewrites](https://mlsanity.com/paper/2305.20088/) (2023)
- [End-to-End Dense Video Captioning with Masked Transformer](https://mlsanity.com/paper/1804.00819/) (2018)
- [HuatuoGPT, towards Taming Language Model to Be a Doctor](https://mlsanity.com/paper/2305.15075/) (2023)
- [Unmasked Teacher: Towards Training-Efficient Video Foundation Models](https://mlsanity.com/paper/2303.16058/) (2023)
- [Quilt-1M: One Million Image-Text Pairs for Histopathology](https://mlsanity.com/paper/2306.11207/) (2023)
- [Multimodal Contrastive Training for Visual Representation Learning](https://mlsanity.com/paper/2104.12836/) (2021)
- [REVEAL: Retrieval-Augmented Visual-Language Pre-Training with Multi-Source Multimodal Knowledge Memory](https://mlsanity.com/paper/2212.05221/) (2022)
- [Retrieval Augmented Classification for Long-Tail Visual Recognition](https://mlsanity.com/paper/2202.11233/) (2022)
- [Cross-Modal and Hierarchical Modeling of Video and Text](https://mlsanity.com/paper/1810.07212/) (2018)
- [Reconstruction Network for Video Captioning](https://mlsanity.com/paper/1803.11438/) (2018)

## Built on by (most cited first, 29 of 29)

- [From AI for Science to Agentic Science: A Survey on Autonomous Scientific Discovery](https://mlsanity.com/paper/2508.14111/) (2025)
- [A Survey of Scientific Large Language Models: From Data Foundations to Agent Frontiers](https://mlsanity.com/paper/2508.21148/) (2025)
- [StreamAgent: Towards Anticipatory Agents for Streaming Video Understanding](https://mlsanity.com/paper/2508.01875/) (2025)
- [MMRC: A Large-Scale Benchmark for Understanding Multimodal Large Language Model in Real-World Conversation](https://mlsanity.com/paper/2502.11903/) (2025)
- [Derm1M: A Million-scale Vision-Language Dataset Aligned with Clinical Ontology Knowledge for Dermatology](https://mlsanity.com/paper/2503.14911/) (2025)
- [MedGround-R1: Advancing Medical Image Grounding via Spatial-Semantic Rewarded Group Relative Policy Optimization](https://mlsanity.com/paper/2507.02994/) (2025)
- [SurgLaVi: Large-Scale Hierarchical Dataset for Surgical Vision-Language Representation Learning](https://mlsanity.com/paper/2509.10555/) (2025)
- [MAKE: Multi-Aspect Knowledge-Enhanced Vision-Language Pretraining for Zero-shot Dermatological Assessment](https://mlsanity.com/paper/2505.09372/) (2025)
- [UniMedVL: Unifying Medical Multimodal Understanding and Generation through Observation-Knowledge-Analysis](https://mlsanity.com/paper/2510.15710/) (2025)
- [SciReasoner: Laying the Scientific Reasoning Ground Across Disciplines](https://mlsanity.com/paper/2509.21320/) (2025)
- [Ophora: A Large-Scale Data-Driven Text-Guided Ophthalmic Surgical Video Generation Model](https://mlsanity.com/paper/2505.07449/) (2025)
- [MoRe: Class Patch Attention Needs Regularization for Weakly Supervised Semantic Segmentation](https://mlsanity.com/paper/2412.11076/) (2024)
- [Neighbor Does Matter: Density-Aware Contrastive Learning for Medical Semi-supervised Segmentation](https://mlsanity.com/paper/2412.19871/) (2024)
- [Watch and Learn: Leveraging Expert Knowledge and Language for Surgical Video Understanding](https://mlsanity.com/paper/2503.11392/) (2025)
- [Recognizing Surgical Phases Anywhere: Few-Shot Test-time Adaptation and Task-graph Guided Refinement](https://mlsanity.com/paper/2506.20254/) (2025)
- [A Survey of Multimodal Ophthalmic Diagnostics: From Task-Specific Approaches to Foundational Models](https://mlsanity.com/paper/2508.03734/) (2025)
- [Towards Dynamic 3D Reconstruction of Hand-Instrument Interaction in Ophthalmic Surgery](https://mlsanity.com/paper/2505.17677/) (2025)
- [EyePCR: A Comprehensive Benchmark for Fine-Grained Perception, Knowledge Comprehension and Clinical Reasoning in Ophthalmic Surgery](https://mlsanity.com/paper/2509.15596/) (2025)
- [Cataract-LMM Large-Scale Multi-Source Multi-Task Benchmark for Deep Learning in Surgical Video Analysis](https://mlsanity.com/paper/2510.16371/) (2025)
- [fine-CLIP: Enhancing Zero-Shot Fine-Grained Surgical Action Recognition with Vision-Language Models](https://mlsanity.com/paper/2503.19670/) (2025)
- [Enhancing Multimodal Large Language Models Complex Reason via Similarity Computation](https://mlsanity.com/paper/2412.09817/) (2024)
- [Multi-Aspect Knowledge-Enhanced Medical Vision-Language Pretraining with Multi-Agent Data Generation](https://mlsanity.com/paper/2512.03445/) (2025)
- [From Understanding to Engagement: Personalized pharmacy Video Clips via Vision Language Models (VLMs)](https://mlsanity.com/paper/2601.05059/) (2026)
- [Toward Modality Gap: Vision Prototype Learning for Weakly-supervised Semantic Segmentation with CLIP](https://mlsanity.com/paper/2412.19650/) (2024)
- [WetCat: Enabling Automated Skill Assessment in Wet-Lab Cataract Surgery Videos](https://mlsanity.com/paper/2506.08896/) (2025)
- [A vision-language model and platform for temporally mapping surgery from video](https://mlsanity.com/paper/2603.22583/) (2026)
- [SurgCoT: Advancing Spatiotemporal Reasoning in Surgical Videos through a Chain-of-Thought Benchmark](https://mlsanity.com/paper/2604.20319/) (2026)
- [SurgNarrator: A Generative Retrieval Framework for Surgical Video Understanding](https://mlsanity.com/paper/2608.04676/) (2026)
- [Video-STLayout Pre-training](https://mlsanity.com/paper/2609.24031/) (2026)

## Abstract (arXiv)

Surgical practice involves complex visual interpretation, procedural skills, and advanced medical knowledge, making surgical vision-language pretraining (VLP) particularly challenging due to this complexity and the limited availability of annotated data. To address the gap, we propose OphCLIP, a hierarchical retrieval-augmented vision-language pretraining framework specifically designed for ophthalmic surgical workflow understanding. OphCLIP leverages the OphVL dataset we constructed, a large-scale and comprehensive collection of over 375K hierarchically structured video-text pairs with tens of thousands of different combinations of attributes (surgeries, phases/operations/actions, instruments, medications, as well as more advanced aspects like the causes of eye diseases, surgical objectives, and postoperative recovery recommendations, etc). These hierarchical video-text correspondences enable OphCLIP to learn both fine-grained and long-term visual representations by aligning short video clips with detailed narrative descriptions and full videos with structured titles, capturing intricate surgical details and high-level procedural insights, respectively. Our OphCLIP also designs a retrieval-augmented pretraining framework to leverage the underexplored large-scale silent surgical procedure videos, automatically retrieving semantically relevant content to enhance the representation learning of narrative videos. Evaluation across 11 datasets for phase recognition and multi-instrument identification shows OphCLIP's robust generalization and superior performance.