{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:58:32Z","timestamp":1785254312383,"version":"3.55.0"},"reference-count":112,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Multimodal natural language processing (NLP) represents a transformative approach in ophthalmology by bridging clinical text and medical imaging to enhance diagnostic accuracy, workflow efficiency, and patient-centered care. The mainstream NLP technologies were applied in ophthalmology, such as self-attention and cross-modality attention in multimodal settings, BERT and GPT in text-focused settings, and vision-focused transformers in imaging-focused settings. The applications of multimodal NLP in ophthalmology cover three key domains as follows: clinical text-image integration for comprehensive data analysis, enhanced screening and diagnostic prediction systems, and improved patient communication and management. With the significant advancements of multimodal NLP applications in ophthalmology, the consequent challenges must be addressed, including data privacy concerns, domain-specific terminology adaptation, model interpretability, standardization of multimodal data, and regulatory validation. Emerging directions (e.g., few-shot learning, real-time interactive systems, and privacy-preserving federated learning) offer potential solutions to current challenges. The successful implementation of multimodal NLP in ophthalmology requires collaborative efforts to develop standardized datasets, refine ethical guidelines, and validate clinical utility. By synthesizing textual and visual data, these technologies are poised to reshape ophthalmic practice, ultimately leading to more precise, accessible, and personalized eye care.<\/jats:p>","DOI":"10.3389\/fmed.2026.1762586","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:00:06Z","timestamp":1785250806000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multimodal natural language processing in ophthalmology: bridging clinical text and medical imaging"],"prefix":"10.3389","volume":"13","author":[{"given":"Shuyan","family":"Qin","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian Hospital Affiliated to Xuzhou Medical University","place":["Suqian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nana","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian Hospital Affiliated to Xuzhou Medical University","place":["Suqian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian Hospital Affiliated to Xuzhou Medical University","place":["Suqian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian Hospital Affiliated to Xuzhou Medical University","place":["Suqian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengfang","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1001\/jama.2024.21700","article-title":"Testing and evaluation of health care applications of large language models: a systematic review","volume":"333","author":"Bedi","year":"2025","journal-title":"JAMA"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1056\/NEJMra2302038","article-title":"Artificial intelligence and machine learning in clinical medicine, 2023","volume":"388","author":"Haug","year":"2023","journal-title":"N Engl J Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1930","DOI":"10.1038\/s41591-023-02448-8","article-title":"Large language models in medicine","volume":"29","author":"Thirunavukarasu","year":"2023","journal-title":"Nat Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e8","DOI":"10.1016\/s2589-7500(19)30217-1","article-title":"Artificial intelligence, the internet of things, and virtual clinics: ophthalmology at the digital translation forefront","volume":"2","author":"Ting","year":"2020","journal-title":"Lancet Digit Health"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e917","DOI":"10.1016\/s2589-7500(23)00201-7","article-title":"Large language models and their impact in ophthalmology","volume":"5","author":"Betzler","year":"2023","journal-title":"Lancet Digit Health"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"102056","DOI":"10.1016\/j.xcrm.2025.102056","article-title":"Metagp: a generative foundation model integrating electronic health records and multimodal imaging for addressing unmet clinical needs","volume":"6","author":"Liu","year":"2025","journal-title":"Cell Rep Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"101372","DOI":"10.1016\/j.preteyeres.2025.101372","article-title":"Pachychoroid disease Spectrum: how multimodal imaging and Oct angiography have improved our knowledge","volume":"107","author":"Viggiano","year":"2025","journal-title":"Prog Retin Eye Res"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"P66","DOI":"10.1016\/j.ophtha.2019.09.025","article-title":"Diabetic retinopathy preferred practice pattern\u00ae","volume":"127","author":"Flaxel","year":"2020","journal-title":"Ophthalmology"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bjophthalmol-2025-egsguidelines","article-title":"European Glaucoma society - 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