arXiv:2603.06665v1 Announce Type: cross Abstract: Large vision-language models (VLMs) often benefit from chain-of-thought (CoT) prompting in general domains, yet its efficacy in medical vision-language tasks remains underexplored. We report a counter-intuitive trend: on medical visual question answering, CoT frequently underperforms direct answering (DirA) across general-purpose and medical-specific models. We attribute this to a \emph{medical perception bottleneck}: subtle, domain-specific cues can weaken visual grounding, and CoT may compound early perceptual uncertainty rather than correct it. To probe this hypothesis, we introduce two training-free, inference-time grounding interventions: (i) \emph{perception anchoring} via region-of-interest cues and (ii) \emph{description grounding} via high-quality textual guidance. Across multiple benchmarks and model families, these interventions improve accuracy, mitigate CoT degradation, and in several settings reverse the CoT--DirA inversion. Our findings suggest that reliable clinical VLMs require robust visual grounding and cross-modal alignment, beyond extending text-driven reasoning chains. Code is available \href{https://github.com/TianYin123/Better_Eyes_Better_Thoughts}{here}.

arXiv:2510.10285v3 Announce Type: replace Abstract: Multimodal large reasoning models (MLRMs) often suffer from hallucinations that stem not only from insufficient visual grounding but also from imbalanced allocation between perception and reasoning processes. Building upon recent interpretability findings suggesting a staged division of attention across layers, we analyze how this functional misalignment leads to two complementary failure modes: perceptual bias in shallow layers and reasoning drift in deeper layers. To alleviate these issues, we propose Functional Head Identification and Class-Conditioned Rescaling , a lightweight, training-free plugin that identifies perception- and reasoning-oriented heads and adaptively rebalances their layerwise contributions. Our method improves reasoning consistency and visual faithfulness without retraining or any architectural modification. Evaluations across three representative MLRMs and five multimodal reasoning benchmarks show an average 4.2% point gain, with less than 1% additional computation and only 9% baseline latency. Beyond empirical improvements, our study provides an interpretable perspective on regulating cross-layer functional dynamics to enhance the reliability of multimodal reasoning.