An integrated language-vision foundation model for conversational diagnostics and triaging in primary eye care

Summary We present Meta-EyeFM, an integrated language-vision foundation model designed for conversational diagnostics and triaging in primary eye care. By combining a large language model (LLM) with eight task-specific vision foundation models (VFMs), Meta-EyeFM dynamically routes user queries and fundus photographs to the most appropriate VFMs (accuracy 96.8%). It demonstrates high performance in detecting ocular diseases (area under the receiver operating curve [AUC] ≥91.2%), differentiating disease severity (AUC ≥82%), identifying ocular signs (AUC ≥77.9%), and predicting systemic conditions like diabetes (AUC ≥79.8%). Meta-EyeFM is 11%–43% more accurate than Gemini-1.5-flash and GPT-4o LLM and generally outperforms junior ophthalmologist and optometrist graders in detecting different eye diseases. Its conversational interface and robust generalizability support its role as a diagnostic decision support tool in community settings. Through self-supervised learning and a user-friendly platform, Meta-EyeFM addresses the scarcity of skilled eye care professionals, offering scalable, explainable AI for enhancing vision screening and disease triage globally.