# OphIn-500K: Curating Web-Scale Visual Instructions for Scaling Ophthalmic Multimodal Large Language Models

arXiv: https://arxiv.org/abs/2605.27916 · HTML: https://mlsanity.com/paper/2605.27916/

## Key facts

- Cited by 1 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 29 of its 54 references that are in the map.
- First posted on arXiv 27 May 2026.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 29 of 29)

- [Emerging Properties in Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.14294/) (2021)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [Robust Speech Recognition via Large-Scale Weak Supervision](https://mlsanity.com/paper/2212.04356/) (2022)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [ZeRO: Memory Optimizations Toward Training Trillion Parameter Models](https://mlsanity.com/paper/1910.02054/) (2019)
- [Contrastive Learning of Medical Visual Representations from Paired Images and Text](https://mlsanity.com/paper/2010.00747/) (2020)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [SLAKE: A Semantically-Labeled Knowledge-Enhanced Dataset for Medical Visual Question Answering](https://mlsanity.com/paper/2102.09542/) (2021)
- [Med-Flamingo: a Multimodal Medical Few-shot Learner](https://mlsanity.com/paper/2307.15189/) (2023)
- [SWIFT:A Scalable lightWeight Infrastructure for Fine-Tuning](https://mlsanity.com/paper/2408.05517/) (2024)
- [Lingshu: A Generalist Foundation Model for Unified Multimodal Medical Understanding and Reasoning](https://mlsanity.com/paper/2506.07044/) (2025)
- [Vision-Language Models for Medical Report Generation and Visual Question Answering: A Review](https://mlsanity.com/paper/2403.02469/) (2024)
- [A Foundation Language-Image Model of the Retina (FLAIR): Encoding Expert Knowledge in Text Supervision](https://mlsanity.com/paper/2308.07898/) (2023)
- [Attention Based Glaucoma Detection: A Large-scale Database and CNN Model](https://mlsanity.com/paper/1903.10831/) (2019)
- [RET-CLIP: A Retinal Image Foundation Model Pre-trained with Clinical Diagnostic Reports](https://mlsanity.com/paper/2405.14137/) (2024)
- [MM-Retinal: Knowledge-Enhanced Foundational Pretraining with Fundus Image-Text Expertise](https://mlsanity.com/paper/2405.11793/) (2024)
- [V2T-CoT: From Vision to Text Chain-of-Thought for Medical Reasoning and Diagnosis](https://mlsanity.com/paper/2506.19610/) (2025)
- [CUNSB-RFIE: Context-aware Unpaired Neural Schr"odinger Bridge in Retinal Fundus Image Enhancement](https://mlsanity.com/paper/2409.10966/) (2024)
- [LLaDA-MedV: Exploring Large Language Diffusion Models for Biomedical Image Understanding](https://mlsanity.com/paper/2508.01617/) (2025)
- [UrFound: Towards Universal Retinal Foundation Models via Knowledge-Guided Masked Modeling](https://mlsanity.com/paper/2408.05618/) (2024)
- [Taming Vision-Language Models for Medical Image Analysis: A Comprehensive Review](https://mlsanity.com/paper/2506.18378/) (2025)
- [EViT-Unet: U-Net Like Efficient Vision Transformer for Medical Image Segmentation on Mobile and Edge Devices](https://mlsanity.com/paper/2410.15036/) (2024)
- [Talk Before You Retrieve: Agent-Led Discussions for Better RAG in Medical QA](https://mlsanity.com/paper/2504.21252/) (2025)
- [Constructing Ophthalmic MLLM for Positioning-diagnosis Collaboration Through Clinical Cognitive Chain Reasoning](https://mlsanity.com/paper/2507.17539/) (2025)
- [Bridging the Gap in Ophthalmic AI: MM-Retinal-Reason Dataset and OphthaReason Model toward Dynamic Multimodal Reasoning](https://mlsanity.com/paper/2508.16129/) (2025)
- [TPOT: Topology Preserving Optimal Transport in Retinal Fundus Image Enhancement](https://mlsanity.com/paper/2411.01403/) (2024)
- [Cracking Instance Jigsaw Puzzles: An Alternative to Multiple Instance Learning for Whole Slide Image Analysis](https://mlsanity.com/paper/2507.08178/) (2025)
- [Fundus-R1: Training a Fundus-Reading MLLM with Knowledge-Aware Reasoning on Public Data](https://mlsanity.com/paper/2604.08322/) (2026)

## Built on by (most cited first, 1 of 1)

- [The Path to Self-Evolving Clinical Systems: Scaling Medical Agents from Assistance to Autonomy](https://mlsanity.com/paper/2607.11175/) (2026)

## Abstract (arXiv)

The advancement of general medical Multimodal Large Language Models (MLLMs) has shown great potential for building conversational assistants to support clinical diagnosis. However, their adaptation to highly specialized domains such as ophthalmology remains underexplored, primarily due to the scarcity of large-scale, domain-specific instruction-tuning data. Existing ophthalmic datasets for conversational agents are often limited in scale and largely rely on images from established public benchmarks, limiting the scalability of ophthalmic MLLMs and their ability to capture real-world clinical complexity. To address this gap, we propose OphIn-Engine, an ophthalmology-specific instruction data curation pipeline that constructs high-quality instruction data from open-access ophthalmology web-scale videos. The pipeline integrates multimodal transcription for extracting image-transcript pairs, visual cue separation and scoring for identifying clinically relevant visual descriptions, and instruction synthesis with quality control for generating accurate and diverse clinical dialogues. Using this engine, we introduce OphIn-500K, a large-scale multimodal ophthalmology instruction-tuning dataset containing over 500,000 instruction instances and more than 151,000 unique images from over 29,000 video clips, formatted as visual question answering (VQA), multi-turn conversational interactions, and chain-of-thought (CoT) reasoning. Built upon this dataset, we further develop OphIn-VL, an ophthalmology-specific MLLM with advanced visual understanding and conversational capabilities. Comprehensive experiments and case studies demonstrate that OphIn-VL achieves superior performance compared with state-of-the-art general medical and domain-specific MLLMs.