The prevalence of vision-threatening eye diseases is a significant global burden, with many cases remaining undiagnosed or diagnosed too late for effective treatment. Large vision-language models (LVLMs) have the potential to assist in understanding anatomical information, diagnosing eye diseases, and drafting interpretations and follow-up plans, thereby reducing the burden on clinicians and improving access to eye care. However, limited benchmarks are available to assess LVLMs’ performance in ophthalmology-specific applications. In this study, we introduce LMOD, a large-scale multimodal ophthalmology benchmark consisting of 21,993 instances across (1) five ophthalmic imaging modalities: optical coherence tomography, color fundus photographs, scanning laser ophthalmoscopy, lens photographs, and surgical scenes; (2) free-text, demographic, and disease biomarker information; and (3) primary ophthalmology-specific applications such as anatomical information understanding, disease diagnosis, and subgroup analysis. In addition, we benchmarked 13 state-of-the-art LVLM representatives from closed-source, open-source, and medical domains. The results demonstrate a significant performance drop for LVLMs in ophthalmology compared to other domains. Systematic error analysis further identified six major failure modes: misclassification, failure to abstain, inconsistent reasoning, hallucination, assertions without justification, and lack of domain-specific knowledge. In contrast, supervised neural networks specifically trained on these tasks as baselines demonstrated high accuracy. These findings underscore the pressing need for benchmarks in the development and validation of ophthalmology-specific LVLMs.

Vision Large Language Models (VLLMs) are transforming the intersection of computer vision and natural language processing; however, the potential of using visual prompts for emotion recognition in these models remains largely unexplored and untapped. Traditional methods in VLLMs struggle with spatial localization and often discard valuable global context. We propose a novel Set-of-Vision prompting (SoV) approach that enhances zero-shot emotion recognition by using spatial information, such as bounding boxes and facial landmarks, to mark targets precisely. SoV improves accuracy in face count and emotion categorization while preserving the enriched image context. Through comprehensive experimentation and analysis of recent commercial or open-source VLLMs, we evaluate the SoV model’s ability to comprehend facial expressions in natural environments. Our findings demonstrate the effectiveness of integrating spatial visual prompts into VLLMs for improving emotion recognition performance.