Imaging disciplines, such as ophthalmology, offer a wide range of opportunities for the beneficial use of artificial intelligence (AI). The analysis of images and data by trained algorithms has the potential to facilitate making the diagnosis and patient care and not just in ophthalmology. If AI brings about advances in clinical practice that benefit patients, this is ethically to be welcomed; however, respect for the self-determination of patients and data security must be guaranteed. Traceability and explainability of the algorithms would strengthen trust in automated decision-making and enable ultimate medical responsibility. It should be noted that algorithms are only as good and unbiased as the data used to train them. If the use of AI is likely to lead to a loss of skills on the part of doctors (deskilling), this must be counteracted, for example through improved training. Accompanying medical ethics research is necessary to identify those aspects of the use of AI that require regulation. In principle, care must be taken to ensure that AI serves people and adapts to their needs, not the other way round.