Although the concept of medical futility has been addressed extensively in other medical fields only a single case report of futility has been raised in the ophthalmic literature.

The definition of medical futility is one of considerable theoretical debate, but in clinical practice, medical futility is a treatment that cannot achieve its intended goals of benefitting the patient.

Many of the debates on medical futility revolve around end-of-life care, and ophthalmologists rarely are involved in these particular discussions.

However, we do manage many acute traumatic, as well as chronic, progressive diseases that can result in blindness.

The decisions concerning these end-of-sight care issues frequently mirror those of end-of-life care.

The goals of this editorial are to address several concepts of medical futility—or in ophthalmology, ocular futility—and to lay out a systematic approach to these complex clinical situations.

Often these decisions are difficult because of the competing ethical principles of doing what is best for the patient (beneficence), avoiding harming the patient (nonmaleficence), and respect for dignity versus acknowledging the patient’s determination of their medical care (patient autonomy) and abandonment.