Deep Expert Injection for Anchoring Retinal VLMs with Domain-Specific Knowledge
This work provides a method to improve the reliability and trustworthiness of ophthalmic AI for clinicians by addressing critical knowledge gaps in existing LVLMs.
The paper addresses the limitations of Large Vision Language Models (LVLMs) in ophthalmic diagnosis, specifically the Perception Gap (failure to resolve fine-grained pathological cues) and the Reasoning Gap (visual evidence overridden by language priors). The proposed EyExIn framework, using a Deep Expert Injection mechanism, significantly enhances domain-specific knowledge embedding and achieves state-of-the-art precision in ophthalmic visual question answering across four benchmarks.
Large Vision Language Models (LVLMs) show immense potential for automated ophthalmic diagnosis. However, their clinical deployment is severely hindered by lacking domain-specific knowledge. In this work, we identify two structural deficiencies hindering reliable medical reasoning: 1) the Perception Gap, where general-purpose visual encoders fail to resolve fine-grained pathological cues (e.g., microaneurysms); and 2) the Reasoning Gap, where sparse visual evidence is progressively overridden by massive language priors in deeper transformer layers, leading to ungrounded hallucinations. To bridge these gaps, we propose EyExIn, a data-efficient framework designed to anchor retinal VLMs with expert knowledge via a Deep Expert Injection mechanism. Our architecture employs an Expert-Aware Dual-Stream encoding strategy that decouples visual representation into a general stream for anatomical context and a specialized expert stream for pathological semantics. To ensure high-fidelity integration, we design a Semantic-Adaptive Gated Fusion module, which dynamically amplifies subtle lesion signals while filtering irrelevant background noise. Furthermore, we introduce Adaptive Deep Expert Injection to embed persistent "Vision Anchors" by integrating fused visual features as residual biases directly into intermediate LLM layers. This mechanism creates a visual shortcut that forces the reasoning stack to remain strictly grounded in visual evidence. Extensive experiments across four benchmarks demonstrate that our model consistently outperforms massive proprietary systems. EyExIn significantly enhances domain-specific knowledge embedding and achieves state-of-the-art precision in ophthalmic visual question answering, advancing the development of trustworthy ophthalmic AI.