This study investigates the current state and growth of artificial intelligence (AI) within ophthalmology, documenting the lengthy history of development regarding AI for medical imaging and diagnosis. In this study, the authors present the results of a bibliographic analysis of 498 scientific articles collected from Web of Science and Scopus that focused on the ethical implications of AI development and AI use within ophthalmology, including imaging and diagnosis from the years 2000 through 2023. The authors present trends in the number of published studies, collaborations among researchers, and prevalent ethical topics, which indicate scholars' shifting focus. The authors identified ophthalmology as the second most researched specialty on AI ethics, seeing a major increase after 2018, compared to other specialties. Common ethical topics included trust, interpretability, fairness, privacy, safety, and transparency. The data showed that the most common imaging modalities for research in AI ethics were fundus imaging and optical coherence tomography (OCT); fundus studies related to fairness and interpretability had been published more frequently than facial imaging and anterior-segment imaging, which raised greater concerns around privacy. While nearly 90% of studies addressed ethics in regard to the development of AI, only 11.5% of studies addressed ethical proposals on future directions, including ethical frameworks and policy recommendations. Within the discussion, the authors address a shift from theoretical to practical applications of AI ethics in ophthalmology, to international collaborations focused on battling bias and protecting patient data in order to regulate the use of AI. To conclude, they highlight the need for comprehensive ethical guidelines and policies to direct the systematic and responsible worldwide incorporation of tools based on AI into ophthalmic practice.