Large Language Models in Ophthalmology Scientific Writing: Ethical Considerations Blurred Lines or Not at All?

& BULL; PURPOSE: To discuss the implications of large language models (LLMs) in ophthalmology research, as well as the associated ethical considerations.& BULL; DESIGN: Perspective.& BULL; METHODS: This discussion reviews the potential uses of LLMs such as ChatGPT in ophthalmology research, highlights the associated threats and ethical considera-tions, and proposes solutions for the use of LLMs in oph-thalmology research and scientific writing.& BULL; RESULTS: With the increasing interest in LLMs, such as ChatGPT, their diverse utility has been widely ex-plored, including their application in research and scien-tific writing. LLMs have the potential to guide researchers throughout the different stages of their research, from idea generation to drafting a scientific piece. However, there are significant ethical concerns and challenges re-lated to scientific integrity in ophthalmology research that should be addressed by scientific journals. Our review of the 10 highest -impact-factor ophthalmology journals re-vealed that the number of journals addressing this topic in their submission guidelines is rapidly increasing. There-fore, we propose certain domains that all journals should consider regarding the use of LLMs in research. & BULL; CONCLUSIONS: As LLMs continue to improve, their use in scientific writing will remain a contentious issue due to the ethical dilemmas involved in determining the appropriate scope of their use. This article reviews the ethical dilemmas related to the use of LLMs in ophthal-mology research and calls for the prompt development of guidelines for their ethical use in manuscript writing as ophthalmology journals update their editorial policies with respect to LLMs. (Am J Ophthalmol 2023;254: 177-181. & COPY; 2023 Elsevier Inc. All rights reserved.)