Dissemination and implementation science for global ophthalmology: closing the last-mile translational gap

Despite remarkable advances in ophthalmic diagnostics and therapeutics over the past decade, the global prevalence of avoidable visual impairment and blindness has remained unchanged. This paradox reflects a crisis of care delivery and the persistent failure to consistently, equitably, and effectively translate evidence-based interventions into routine practice for the millions who need them most. Dissemination and implementation (D&I) science offers ophthalmology rigorous, evidence-informed frameworks to close this last-mile translational gap. Drawing on the established body of D&I science theory, methods, and applications, this review argues that ophthalmology has been slow to harness these tools, and that doing so now is imperative. We examine the current evidence for D&I science applications across key domains of global eye care: equitable care delivery in the US, global eye health in low- and middle-SDI regions, gender equity, and the implementation of artificial intelligence-based diagnostic tools. Across each domain, we identify both promising examples of D&I science in action and critical gaps in evidence, equity, and sustainability. Achieving vision health equity worldwide will require ophthalmology to treat the dissemination, implementation, and sustainment of evidence-based eye care as central to its mission as the development of the innovations themselves.