The 21 papers presented at OMIA 2020 were carefully reviewed and selected from 34 submissions. The papers cover various topics in the field of ophthalmic medical image analysis and challenges in terms of reliability and validation, number and type of conditions considered, multi-modal analysis (e.g., fundus, optical coherence tomography, scanning laser ophthalmoscopy), novel imaging technologies, and the effective transfer of advanced computer vision and machine learning technologies.