The Integration of Artificial Intelligence in Ophthalmology: Augmenting Clinical Decision or Clinical Dependency?

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Year : 2026 | Volume : 16 | Issue : 01 | Page :
    By

    Sankhajyoti Saha,

  • ,

  1. Assistant Professor, Bhawanipur College of Creative Arts and & Applied Sciences, Kolkata, India
  2. Assistant Professor, 1Bhawanipur College of Creative Arts and & Applied Sciences, Kolkata, India

Abstract

The diagnostic accuracy of artificial intelligence (AI) algorithms for glaucoma and diabetic retinopathy screening is on par with or higher than that of skilled doctors. Their acceptance has accelerated due to regulatory clearances, practical implementation in telehealth networks, and growing proof of cost-effectiveness. However, this very success raises a question that the field has been reluctant to address: are we unintentionally undermining the clinical reasoning abilities of the upcoming generation of ophthalmologists as AI systems take over tasks that were once the foundation of ophthalmic training, such as grading fundus photos, interpreting optical coherence tomography, and identifying subtle disc changes? To maintain independent clinical judgment in an AI-augmented era, this viewpoint looks at the growing evidence on automation bias and diagnostic deskilling in medicine, considers how these phenomena may specifically manifest in ophthalmology, and suggests that the field should purposefully redesign residency curricula.

Keywords: Artificial intelligence, ophthalmology, diabetic retinopathy screening, glaucoma detection, automation bias.

[This article belongs to Research and Reviews: A Journal of Health Professions ]

How to cite this article:
Sankhajyoti Saha. The Integration of Artificial Intelligence in Ophthalmology: Augmenting Clinical Decision or Clinical Dependency?. Research and Reviews: A Journal of Health Professions. 2026; 16(01):-.
How to cite this URL:
Sankhajyoti Saha. The Integration of Artificial Intelligence in Ophthalmology: Augmenting Clinical Decision or Clinical Dependency?. Research and Reviews: A Journal of Health Professions. 2026; 16(01):-. Available from: https://journals.stmjournals.com/rrjohp/article=2026/view=242254


References

  1. Ling XC, Chen HS, Yeh PH, et al. Deep Learning in Glaucoma Detection and Progression Prediction: A Systematic Review and Meta-Analysis. Biomedicines. 2025;13(2):420. Published 2025 Feb 10. doi:10.3390/biomedicines13020420
  2. Wu JH, Nishida T, Weinreb RN, Lin JW. Performances of Machine Learning in Detecting Glaucoma Using Fundus and Retinal Optical Coherence Tomography Images: A Meta-Analysis. Am J Ophthalmol. 2022;237:1-12. doi:10.1016/j.ajo.2021.12.008
  3. Pinto I, Olazarán Á, Jurío D, et al. Improving diabetic retinopathy screening using artificial intelligence: design, evaluation and before-and-after study of a custom development. Front Digit Health. 2025;7:1547045. Published 2025 Jun 19. doi:10.3389/fdgth.2025.1547045.
  4. Boyle J, Vignarajan J, Saha S. Automated Diabetic Retinopathy Diagnosis for Improved Clinical Decision Support. Stud Health Technol Inform. 2024;310:1490-1491. doi:10.3233/SHTI231259.
  5. Pershina-Miliutina AP, Kozlov EV, Lysukhin DD, Aredov AV, Kovaleva EV, Mokrysheva NG. Review of medical decision support systems for the diagnosis of diabetic retinopathy. Diabetes Mellit. 2025;28(5):460-470. doi:10.14341/dm13354
  6. Daich Varela M, Sen S, De Guimaraes TAC, et al. Artificial intelligence in retinal disease: clinical application, challenges, and future directions. Graefes Arch Clin Exp Ophthalmol. 2023;261(11):3283-3297. doi:10.1007/s00417-023-06052-x.
  7. Natali C, Marconi L, Dias Duran LD, Cabitza F. AI-induced deskilling in medicine: A mixed-method review and research agenda for healthcare and beyond. Artif Intell Rev. 2025;58(11). doi:10.1007/s10462-025-11352-1.
  8. Monteith S, Glenn T, Geddes JR, et al. Artificial intelligence and deskilling in medicine. Br J Psychiatry. Published online January 8, 2026. doi:10.1192/bjp.2025.10496.
  9. El Tarhouny S, Farghaly A. Deskilling dilemma: brain over automation. Front Med (Lausanne). 2026;13:1765692. Published 2026 Feb 3. doi:10.3389/fmed.2026.1765692.
  10. Rosbach E, Ganz J, Ammeling J, Riener A, Aubreville M. Automation bias in AI-assisted medical decision-making under time pressure in computational pathology. arXiv [csHC]. Published online 1 November 2024. doi:10.48550/arXiv.2411.00998.
  11. Mazouri-Karker S, Bjelogrlic M, Audétat MC. IA et raisonnement clinique : entre promesses et risques de « deskilling » (partie 1) [AI and clinical reasoning : between promises and the risks of “deskilling”]. Rev Med Suisse. 2026;22(950):5-7. Published 2026 Feb 18. doi:10.53738/REVMED.2026.22.950.e48311.
  12. Mezrich JL. Automation bias and overconfidence in artificial intelligence and associated legal implications. Clin Imaging. 2026;132:110745. doi:10.1016/j.clinimag.2026.110745.
  13. Paul S, Kim C, Shieh D, et al. Impact of an artificial intelligence algorithm on diabetic retinopathy grading by ophthalmology residents. medRxiv. Published online 2023. doi:10.1101/2023.08.05.23293692.
  14. Saadeh MI, Janhonen J, Beer E, Castelyn C, Hoffman DN. Automation complacency: risks of abdicating medical decision making. AI Ethics. 2025;5(6):5783-5793. doi:10.1007/s43681-025-00825-2.
  15. Nguyen V, Iyengar S, Rasheed H, et al. Expert-Level Detection of Referable Glaucoma from Fundus Photographs in a Safety Net Population: The AI and Teleophthalmology in Los Angeles Initiative. Preprint. medRxiv. 2024;2024.08.25.24312563. Published 2024 Aug 26. doi:10.1101/2024.08.25.24312563.
  16. Fendouli I, Aoun SB, Maamouri R, Sakji F, Slim S, Amri MC. Assessment of ophthalmology residents’ perspectives on the utilization of artificial intelligence in contemporary practices. Acta Ophthalmol. 2025;103(S284). doi:10.1111/aos.17409.
  17. Najafi A, Babaei S, Sadoughi MM, Kalantarion M, Sadatmoosavi A. Impact of Artificial Intelligence on the Knowledge, Attitude, and Performance of Ophthalmology Residents: A Systematic Review. J Ophthalmic Vis Res. 2025;20:10.18502/jovr.v20.17029. Published 2025 Jul 30. doi:10.18502/jovr.v20.17029.
  18. Valikodath NG, Cole E, Ting DSW, et al. Impact of Artificial Intelligence on Medical Education in Ophthalmology. Transl Vis Sci Technol. 2021;10(7):14. doi:10.1167/tvst.10.7.14
  19. Muntean GA, Groza A, Marginean A, et al. Artificial Intelligence for Personalised Ophthalmology Residency Training. J Clin Med. 2023;12(5):1825. Published 2023 Feb 24. doi:10.3390/jcm12051825.

Regular Issue Subscription Review Article
Volume 16
Issue 01
Received 28/04/2026
Accepted 30/04/2026
Published 30/04/2026
Publication Time 2 Days


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