Mendelian randomisation in ophthalmology: An overview and practical guide for clinicians

Mendelian randomisation (MR) is an epidemiological approach that leverages natural genetic variation to strengthen causal inference. When applied rigorously and interpreted within a broader framework of evidence, it offers a powerful tool to advance understanding and inform clinical translation. However, misuse or misinterpretation of the technique is increasingly common and risks introducing spurious or implausible findings into the scientific literature. Violation of core underlying assumptions and lack of clear gene-environment equivalence often negates meaningful clinical translation, and overreliance on MR results without triangulation with other lines of evidence may lead to misleading causal claims. As the use of MR continues to expand within ophthalmic research, it is increasingly important for clinicians and researchers to be equipped to critically appraise and interpret such studies.