Agentic artificial intelligence in ophthalmology: Toward autonomous, adaptive, and ethical eye care

Agentic artificial intelligence (AI) represents a new generation of intelligent systems capable of autonomous goal-directed reasoning, dynamic decision-making, and coordinated action. Unlike conventional task-specific algorithms, agentic AI systems can perceive, plan, and act within complex healthcare environments with minimal supervision. Ophthalmology, an image-intensive and data-rich specialty, provides an ideal field for exploring this paradigm. This Perspective outlines the conceptual framework of agentic AI, its emerging ophthalmic applications, and the technical, ethical, and regulatory challenges that must be addressed to ensure safe and effective clinical translation. Properly developed, agentic AI has the potential to enable intelligent diagnostic assistants, adaptive surgical partners, and autonomous population health agents; thereby, it has the potential to transform future models of ophthalmic care.