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This narrative review synthesizes evidence from 76 empirical studies to evaluate the quality and reliability of ophthalmic video content. We identify a persistent engagement paradox, where algorithm-driven metrics such as view counts and shares often favor simplified, emotionally resonant, or visually striking narratives over medically accurate and balanced counseling. Clinician-produced content generally showed higher clinical integrity in the included studies, but it often received lower engagement than peer-led experiential narratives. Beyond patient-facing education, we explore the emerging role of video platforms as professional-facing education for residents, highlighting the risks of survivor bias in unedited or curated operative footage. Furthermore, the visual-centric nature of ophthalmology introduces unique ethical challenges, particularly regarding the anonymization of recognizable facial features and the permanence of digital consent. 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