Deep Expert Injection for Anchoring Retinal VLMs with Domain-Specific Knowledge

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Main Authors: Lu, Shuai, Wang, Meng, Guo, Jia, Du, Jiawei, Liu, Bo, Yang, Shengzhu, Zhang, Weihang, Fu, Huazhu, Li, Huiqi
Format: Preprint
Published: 2026
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author Lu, Shuai
Wang, Meng
Guo, Jia
Du, Jiawei
Liu, Bo
Yang, Shengzhu
Zhang, Weihang
Fu, Huazhu
Li, Huiqi
author_facet Lu, Shuai
Wang, Meng
Guo, Jia
Du, Jiawei
Liu, Bo
Yang, Shengzhu
Zhang, Weihang
Fu, Huazhu
Li, Huiqi
contents 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.
format Preprint
id arxiv_https___arxiv_org_abs_2603_07131
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Deep Expert Injection for Anchoring Retinal VLMs with Domain-Specific Knowledge
Lu, Shuai
Wang, Meng
Guo, Jia
Du, Jiawei
Liu, Bo
Yang, Shengzhu
Zhang, Weihang
Fu, Huazhu
Li, Huiqi
Computer Vision and Pattern Recognition
Artificial Intelligence
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.
title Deep Expert Injection for Anchoring Retinal VLMs with Domain-Specific Knowledge
topic Computer Vision and Pattern Recognition
Artificial Intelligence
url https://arxiv.org/abs/2603.07131