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This research introduces dedicated gaze tokens as a supervision signal, enabling Vision-Language Models (VLMs) to emulate the sequential visual search patterns of radiologists rather than relying solely on text-based intermediate reasoning. By aligning model attention with human eye-tracking data from datasets like MIMIC-EYE, the approach achieves state-of-the-art performance in medical imaging while improving out-of-domain robustness for visually grounded tasks.
Thinking with Gaze: Sequential Eye-Tracking as Visual Reasoning Supervision for Medical VLMs
arXiv:2603.06697v2 Announce Type: replace-cross Abstract: Vision--language models (VLMs) process images as visual tokens, yet their intermediate reasoning is often carried out in text, which can be suboptimal for visually grounded radiology tasks. Radiologists instead diagnose via sequential visual search; eye-tracking captures this process as time-ordered gaze trajectories that reveal how evidence is acquired over time. We use eye-gaze as supervision to guide VLM reasoning by introducing a small set of dedicated gaze tokens. These tokens are trained to predict gaze-selected image patch indices in temporal order, encouraging the model to follow human-like evidence acquisition and integration. Experiments on MIMIC-EYE and multiple external zero-shot benchmarks show consistent gains over baselines, achieving state-of-the-art in-domain performance and improved out-of-domain robustness. These results highlight temporally ordered gaze as an effective supervision signal for learning visually grounded medical reasoning.
Abstract:Vision--language models (VLMs) process images as visual tokens, yet their intermediate reasoning is often carried out in text, which can be suboptimal for visually grounded radiology tasks. Radiologists instead diagnose via sequential visual search; eye-tracking captures this process as time-ordered gaze trajectories that reveal how evidence is acquired over time. We use eye-gaze as supervision to guide VLM reasoning by introducing a small set of dedicated gaze tokens. These tokens are trained to predict gaze-selected image patch indices in temporal order, encouraging the model to follow human-like evidence acquisition and integration. Experiments on MIMIC-EYE and multiple external zero-shot benchmarks show consistent gains over baselines, achieving state-of-the-art in-domain performance and improved out-of-domain robustness. These results highlight temporally ordered gaze as an effective supervision signal for learning visually grounded medical reasoning.
Computer Vision and Pattern Recognition (cs.CV); Artificial Intelligence (cs.AI)
arXiv:2603.06697 [cs.CV]
(or arXiv:2603.06697v2 [cs.CV] for this version)
https://doi.org/10.48550/arXiv.2603.06697 Focus to learn more arXiv-issued DOI via DataCite
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