Artificial intelligence (AI) has gained significant attention in healthcare consultation due to its potential to improve clinical workflow and enhance medical communication. However, owing to the complex nature of medical information, large language models (LLM) trained with general world knowledge might not possess the capability to tackle medical-related tasks at an expert level. Here, we introduce EyeGPT, a specialized LLM designed specifically for ophthalmology, using three optimization strategies including role-playing, finetuning, and retrieval-augmented generation. In particular, we proposed a comprehensive evaluation framework that encompasses a diverse dataset, covering various subspecialties of ophthalmology, different users, and diverse inquiry intents. Moreover, we considered multiple evaluation metrics, including accuracy, understandability, trustworthiness, empathy, and the proportion of hallucinations. By assessing the performance of different EyeGPT variants, we identify the most effective one, which exhibits comparable levels of understandability, trustworthiness, and empathy to human ophthalmologists (all Ps>0.05). Overall, ur study provides valuable insights for future research, facilitating comprehensive comparisons and evaluations of different strategies for developing specialized LLMs in ophthalmology. The potential benefits include enhancing the patient experience in eye care and optimizing ophthalmologists' services.

通过三种优化策略，我们引入了专门设计用于眼科学的 EyeGPT，该模型的综合评估框架包括不同领域的眼科学数据集、不同用户和多样化的查询意图。该模型在可理解性、可信度和同理心方面与人类眼科医生相当，为开发专门的大型语言模型在眼科学中提供了有价值的见解。

EyeGPT: 大型语言模型的眼科助理