About

Julian Lim is an Associate Professor in the Department of History at Johns Hopkins University. His research and teaching focus on immigration, borders, and race, with a particular interest in how migration and immigration law shape notions of belonging and state power. Trained in both history and law, Lim pays close attention to the historical development of immigration policy and law, especially within the context of transnational methodologies and relational approaches to race. His work explores the connections between Asian, Latinx, African American, and Indigenous peoples within the U.S. and across national boundaries. Lim's scholarly contributions include his first book, 'Porous Borders: Multiracial Migrations and the Law in the U.S.-Mexico Borderlands,' which examines the history of diverse immigrants in the borderlands and the development of immigration law on both sides. His ongoing research involves a project titled 'Powers to Exclude: Restriction in an Era of American Expansion,' which analyzes contestations over U.S. territorial control and border expansion from the 1870s to 1930, framing the origins of federal immigration law within broader struggles over U.S. empire and sovereignty. His work has been recognized with multiple awards and fellowships, including a National Endowment for the Humanities Fellowship and a Stanford Humanities Center Fellowship.

Research topics

• Medicine
• Ophthalmology
• Surgery
• Internal medicine
• Optometry
• Psychology
• Pediatrics

Selected publications

• Reference Standard for Validation of Age-Related Macular Degeneration Screening Algorithms

  Ophthalmology · 2026-04-01

  articleOpen access

  PURPOSE: Artificial intelligence (AI)-based screening models hold promise for identifying individuals with undiagnosed age-related macular degeneration (AMD) in nonspecialist settings. A standardized reference framework for image labeling is needed to enable consistent training, validation, and deployment of AI-based screening algorithms. The goal of the present study was to establish expert consensus on an image-based reference standard for labeling AMD. DESIGN: Modified Delphi consensus study. PARTICIPANTS: Fellowship-trained retina specialists, ophthalmologists, AI specialists, and imaging specialists. METHODS: A prespecified Delphi process was conducted using structured surveys. Over 2 rounds, panelists assessed opinions on existing reference standards, including the Age-Related Eye Disease Study scale and Beckman scale, as well as imaging methods such as color, OCT, and autofluorescence. The surveys also evaluated imaging features of AMD, including drusen, pseudodrusen, and pigment changes, as well as referral criteria. Consensus was defined using a 9-point Likert scale, with predefined statistical thresholds for agreement. MAIN OUTCOME MEASURES: Agreement on key elements of a reference standard. RESULTS: Consensus was reached on adopting the Beckman classification as the level 1 reference standard (median score, 8; agreement). OCT use for identifying key AMD features, including drusen, geographic atrophy (GA), and choroidal neovascularization, also reached consensus (median scores, 8.5-9; agreement). Pigment change detection did not reach consensus (median, 7.5; uncertain), and screening age thresholds showed nonconsensus (median, 8; uncertain). Referral thresholds reached consensus, including urgent referral for neovascular AMD and nonurgent referral for GA and intermediate AMD (median, 9; agreement). CONCLUSIONS: This study defined a consensus-based reference standard for labeling AMD from images for AI-based screening. These recommendations are intended to support consistent AI model development and evaluation, while remaining distinct from clinical practice guidelines. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

  PublisherDOI

• GlaucomaVLM : a domain-specific vision-language model for glaucoma

  2026-01-16

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• FedSim: foundational federated multi-task learning for ophthalmic diagnostics

  2026-01-16

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• Reduction in Pigment Epithelial Detachment Thickness with Faricimab versus Aflibercept 2 mg during Head-to-Head Dosing in TENAYA/LUCERNE

  Ophthalmology Science · 2026-03-10

  articleOpen access1st authorCorresponding

  Purpose: To evaluate the effects of dual angiopoietin-2 (Ang-2)/VEGF-A pathway inhibition with faricimab versus VEGF pathway inhibition with aflibercept 2 mg on pigment epithelial detachment (PED) in patients with neovascular age-related macular degeneration (nAMD). Design: TENAYA/LUCERNE (NCT03823287/NCT03823300) post hoc analysis. Participants: Patients with treatment-naïve nAMD. Methods: Patients were randomized 1:1 to faricimab 6 mg up to every 16 weeks (n = 665) after 4 initial every-4-week (Q4W) doses or aflibercept 2 mg every 8 weeks (n = 664) after 3 Q4W doses. Pigment epithelial detachment was defined as retinal pigment epithelium (RPE) elevation width ≥350 μm and graded as predominantly/purely serous (serous PED) or predominantly/only fibrovascular (fibrovascular PED). Large PED definition: thickness ≥125 μm. Main Outcome Measures: Pigment epithelial detachment thickness change from baseline during initial 12-week head-to-head dosing, proportion of patients with serous PED at the end of head-to-head dosing, and time to first reduction of maximum PED thickness by 50%. Results: = 0.0258). In eyes with large PED at baseline, the cumulative incidence of PEDs achieving time to first reduction of maximum PED thickness by 50% at week 12 was 35.3% with faricimab versus 25.7% with aflibercept 2 mg. The corresponding incidence in eyes with serous PED at baseline was 61.1% with faricimab versus 51.8% with aflibercept 2 mg. The incidence of RPE tears was low (faricimab, 2.9%; aflibercept 2 mg, 1.5%). Conclusions: In TENAYA/LUCERNE, dual Ang-2/VEGF-A inhibition with faricimab elicited greater improvements in PED outcomes versus aflibercept 2 mg during head-to-head dosing. These findings are consistent with the greater drying of retinal fluid with faricimab during head-to-head dosing, which may allow for rapid treatment interval extension. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

  PublisherOA PDFDOI

• Anatomically guided vision–language model for efficient OCT disease classification and reporting

  2026-01-16

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• OCT to OCTA translation using Brownian bridge diffusion model

  2026-01-16

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  PublisherDOI

• International consensuses and guidelines on rhegmatogenous retinal detachment (RRD) surgery by the Asia-Pacific Vitreo-retina Society (APVRS), the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO) and the Academia Retina Internationalis (ARI)

  Asia-Pacific Journal of Ophthalmology · 2025-09-01 · 1 citations

  articleOpen access

  PURPOSE: To establish expert consensus on the contemporary surgical management of rhegmatogenous retinal detachment (RRD) using a structured Delphi approach. METHODS: A panel of experienced vitreoretinal surgeons participated in a multiround Delphi survey evaluating statements related to surgical approach, vitrectomy techniques, tamponade selection, anesthesia, postoperative care, special populations, and future technologies. Consensus was defined as ≥ 75 % agreement. Voting outcomes were analyzed to identify areas of agreement and topics requiring further discussion. RESULTS: Strong consensus emerged on tailoring surgical choice to patient age, lens status, and retinal break characteristics. Scleral buckle (SB) was preferred in younger, phakic patients, while pars plana vitrectomy (PPV) was favored in pseudophakic eyes and complex detachments. Pneumatic retinopexy was supported for limited superior breaks. Small-gauge vitrectomy (23-27 gauge, G), meticulous peripheral vitreous management, and judicious use of perfluorocarbon liquids were widely endorsed. Postoperative positioning, careful intraocular pressure monitoring, and early intervention for macula-on detachments were emphasized. Moreover, macula-off retinal detachment (RD) may carry good prognosis especially in young patients. Areas of ongoing debate included the comparative benefit of PPV versus SB depending on lens status, the default use of silicone oil in complex detachments, and adoption of 27 G+ instruments in pediatric cases. Emerging technologies, including widefield imaging, intraoperative optical coherence tomography, artificial intelligence-assisted analysis, and pharmacologic adjuvants, were recognized as promising but require further validation. CONCLUSIONS: This Delphi study provides structured guidance on RRD management while identifying areas of ongoing debate. Consistently, individualized surgical strategy, meticulous vitreous management, and careful postoperative care remain central to optimizing anatomical and functional outcomes, highlighting the importance of clinical judgment in evolving surgical practice.

  PublisherDOI

• International Consensuses and Guidelines on the Etiology, Diagnosis and Management of Intraocular Foreign Bodies (IOFBs) by the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO), the Asia-Pacific Vitreo-retina Society (APVRS), and the Academia Retina Internationalis (ARI)

  American Journal of Ophthalmology · 2025-10-08 · 1 citations

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  PublisherDOI

• Compact vision language models enable efficient and interpretable optical coherence tomography through layer-specific multimodal learning

  Communications Medicine · 2025-12-27

  articleOpen access

  Translating the intricate anatomical signatures of retinal disease from optical coherence tomography (OCT) B-scans into clear, accurate clinical narratives demands algorithms that seamlessly fuse visual features with domain expertise. We curated a multimodal dataset of 40,000 OCT B-scans from public repositories and private clinical cohorts, each paired with expert-validated summaries spanning six conditions: diabetic macular edema, diabetic retinopathy, geographic atrophy, drusen, choroidal neovascularization, and healthy retina. We introduce LO-VLM, a compact (247M parameter) vision-language model (VLM) that infuses anatomical guidance into both encoder and decoder for free-form summary generation and multiclass disease classification. Benchmarking against state-of-the-art RetinaVLM, LLaVA-Med, and a ViT vision only model demonstrates superior performance. In a blinded evaluation by three board certified retina specialists, LO-VLM narratives achieves a mean = 8.5 (standard deviation = 1.15) out of 10, compared to a mean = 5.5 (standard 32 deviation = 1.13) for RetinaVLM (p < 0.0001). In quantitative evaluations, LO-VLM achieves an SBERT similarity of 80.3% and a BERTScore F1 of 71.5%, representing improvements of 8.2% and 28.8% over specialized VLM baselines. For disease classification, LO-VLM reaches 96% accuracy (F1 = 96%), outperforming ViT by 13% and exceeding medical VLM benchmarks by over 62% (p < 0.05). By reconciling interpretability with computational efficiency, LO-VLM establishes a paradigm for efficient AI models in OCT interpretation. Eye diseases such as diabetic retinopathy and macular degeneration can cause vision loss if not detected early. Doctors use a type of imaging called optical coherence tomography (OCT) to examine the layers of the retina, but interpreting the images obtained can be time-consuming and requires specialist training. In this study, we developed LO-VLM, an artificial intelligence system that learns from both images and descriptions written by experts to enable analysis of OCT scans. Using 40,000 examples, it can accurately identify different retinal diseases and generate clear, human readable summaries. LO-VLM achieves high accuracy and produces reports clinicians find useful. This technology could support faster, more consistent eye disease diagnosis and provide interpretation similar to that seen by specialists in routine and remote care settings. Wang et al at introduce a dynamic, network-based tool to predict the risk of hepatic encephalopathy in patients with cirrhosis. The model integrates expert knowledge with data-driven insights to enable early prediction and risk stratification across diverse patient populations.

  PublisherDOI

• Systematic review of clinical practice guidelines for the management of neovascular age-related macular degeneration

  Eye · 2025-05-15 · 5 citations

  reviewOpen access1st authorCorresponding

  BACKGROUND/OBJECTIVES: To assess geographically global clinical practice guidelines (CPGs) for neovascular age-related macular degeneration (nAMD) management. METHODS: A systematic literature review (SLR) of CPGs for nAMD management was conducted using Embase and MEDLINE databases, Guideline Central, Health Technology Assessment bodies, professional ophthalmology associations, and backwards citation tracking. CPGs published between January 2010-October 2023 were included and independently assessed by four reviewers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II). CPGs were qualitatively assessed for anatomical measurements (optical coherence tomography [OCT] and visual acuity [VA]). PROSPERO identification is CRD42023473223. RESULTS: Nine of 147 identified global CPGs were included in the SLR for diagnosis, treatment, and disease monitoring for nAMD. Overall AGREE II scores were 62-95 (mean [standard deviation] score 75 [10.6]). Strongest domains were Scope and Purpose (86.6 [11.0]), Clarity of Presentation (84.3 [13.0]), and Editorial Independence (89.1 [15.4]); Stakeholder Involvement (63.4 [16.6]), Applicability (73.0 [12.6]), and Rigor of Development (55.4 [25.9]) were lowest. 4/9 CPGs were "Recommended" by reviewers, and 5/9 were "Recommended with Modifications". All CPGs recommended OCT for initial diagnosis. 2/9 CPGs did not mention VA. For managing pharmacological interventions, 4/9 CPGs recommended using VA, and three recommended OCT. Eight CPGs recommended using either VA or OCT for disease monitoring while on anti-vascular endothelial growth factor (VEGF) treatment. 6/9 CPGs recommended screening for VA and 7/9 CPGs recommended using OCT to change anti-VEGF intervals. CONCLUSION: CPG methods, recommendations on applicability in resource-constrained systems, and patient advocacy/perspectives will improve CPG trustworthiness and transparency.

  PublisherOA PDFDOI

Recent grants

• Differential artery-vein analysis in OCT angiography for objective classification of diabetic retinopathy

  NIH · $1.7M · 2020–2025

Frequent coauthors

• Xincheng Yao

  University of Illinois Chicago

  69 shared

• Douglas A. Jabs

  Bloomberg (United States)

  68 shared

• Jennifer E. Thorne

  Johns Hopkins University

  48 shared

• John H. Kempen

  Harvard University

  47 shared

• Neil M. Bressler

  Johns Hopkins University

  46 shared

• Minhaj Nur Alam

  45 shared

• David Le

  University of Illinois Chicago

  44 shared

• Felix Y. Chau

  University of Illinois Chicago

  43 shared

Education

• Retina Fellowship Medical and Surgical 2 years, Wilmer Eye Institute Ophthalmology

  Johns Hopkins Medicine

• MD with Distinction

  Northwestern University Feinberg School of Medicine

• Ophthalmology Residency, Ophthalmology

  University of Illinois at Chicago

Awards & honors

• WHA Ray Allen Billington Prize
• IEHS Carlton C. Qualey Memorial Article Award