EXHIBIT 4.1


                           AMENDMENT TO RIGHTS AGREEMENT

         AMENDMENT, dated as of February 25, 1998 (this "AMENDMENT"), to the
Rights Agreement dated as of December 31, 1997 (the "RIGHTS AGREEMENT), between
OPHTHALMIC IMAGING SYSTEMS, a California corporation (the "COMPANY"), and
AMERICAN SECURITIES TRANSFER, INC. (the "RIGHTS AGENT").

         WHEREAS, the Company has entered into a Stock Purchase Agreement with
Premier Laser Systems, Inc, a California corporation ("PREMIER"), of even date
herewith (the "STOCK PURCHASE AGREEMENT") pursuant to which Premier will acquire
in excess of 50% of the Company's Common Shares (as defined in the Rights
Agreement) and commence a tender offer to acquire the remaining Common Shares
not already owned by Premier;

         WHEREAS, the Company and the Rights Agent entered into the Rights
Agreement which specified the terms of the Rights (as defined therein);

         WHEREAS, the Company and the Rights Agent desire to amend the Rights
Agreement in accordance with Section 27 of the Rights Agreement to permit the
purchase of Common Shares pursuant to the Stock Purchase Agreement without
causing a Distribution Date under the terms of the Rights Agreement; and

         WHEREAS, the Board of Directors of the Company has voted in favor of
this Amendment at a meeting of the Board of Directors duly called and held.

         NOW, THEREFORE, in consideration of the premises and the mutual
agreements set forth in the Rights Agreement and this Amendment, the parties
hereto agree as follows:

         1. AMENDMENT TO RIGHTS AGREEMENT. The Rights Agreement shall be amended
as follows:

                  (a) Section 1(a) of the Rights Agreement is hereby deleted in
its entirety and replaced by the following:

                           "(a) "ACQUIRING PERSON" shall mean any Person (as
                  such term is hereinafter defined) who or which, together with
                  all Affiliates and Associates (as such terms are hereinafter
                  defined) of such Person, shall be the Beneficial Owner (as
                  such term is hereinafter defined) of 20% or more of the Common
                  Shares of the Company then-outstanding, but shall not include
                  the Company, any Subsidiary (as such term is hereinafter
                  defined) of the Company, any employee benefit plan of the
                  Company or any Subsidiary of the Company, or any entity
                  holding Common Shares for or pursuant to such plan.
                  Notwithstanding the foregoing, Premier Laser Systems, Inc., a
                  corporation which as of the date hereof has filed a Statement
                  on Schedule 13D (a "SCHEDULE 13D") under the Exchange Act (as
                  such term is hereinafter defined), or any Affiliate or
                  Associate thereof





                  (together, "PREMIER LASER") shall not be deemed an "ACQUIRING
                  PERSON"); PROVIDED, HOWEVER, that if after the Close of
                  Business (as such term is hereinafter defined) on February 25,
                  1998 (the "EFFECTIVE DATE"), Premier Laser shall become the
                  Beneficial Owner of an additional 1% or more of the Common
                  Shares of the Company then-outstanding from that number of
                  Common Shares Beneficially Owned by Premier Laser as of the
                  Close of Business on the Effective Date, then Premier Laser
                  shall be deemed an "ACQUIRING PERSON"; PROVIDED, FURTHER, that
                  in the event Premier Laser (i) reduces its ownership of Common
                  Shares of the Company and thereafter shall become the
                  Beneficial Owner of any additional Common Shares of the
                  Company, then Premier Laser shall be deemed an "ACQUIRING
                  PERSON", or (ii) reduces its ownership of Common Shares of the
                  Company below 20% or more of the Common Shares of the Company
                  then-outstanding, then Premier Laser will be treated like any
                  other holder of the Common Shares of the Company for purposes
                  of determining whether it is an "ACQUIRING PERSON".
                  Notwithstanding the foregoing, no Person shall become an
                  "ACQUIRING PERSON" as a result of an acquisition of Common
                  Shares of the Company which, by reducing the number of shares
                  outstanding, increases the proportionate number of shares
                  Beneficially Owned by such Person to 20% or more of the Common
                  Shares of the Company then-outstanding (or, in the case of
                  Premier Laser, by an additional 1% or more of the Common
                  Shares of the Company then-outstanding than Premier Laser
                  Beneficially owned as of the Close of Business on the
                  Effective Date, or in the event Premier Laser reduces its
                  ownership of the Common Shares of the Company after the
                  Effective Date, by any additional Common Shares of the
                  Company); PROVIDED, HOWEVER, that if a Person should become
                  the Beneficial Owner of 20% or more of the Common Shares of
                  the Company then-outstanding (or, in the case of Premier
                  Laser, an additional 1% or more of the Common Shares of the
                  Company then-outstanding than Premier Laser Beneficially Owned
                  as of the Close of Business on the Effective Date) by reason
                  of share purchases by the Company and shall, after such share
                  purchases by the Company, become the Beneficial Owner of any
                  additional Common Shares of the Company, then such Person
                  shall be deemed to be an "ACQUIRING PERSON" for any purpose of
                  this Agreement."

         2. REFERENCE TO AND EFFECT ON RIGHTS AGREEMENT. On and after the date
of this Amendment, each reference in the Rights Agreement to the term
"Agreement", or to "hereof", "hereunder", or "herein" should be deemed to refer
to the Rights Agreement as amended hereby.

         3. EFFECTIVE DATE. This Amendment and the amendments to the Rights
Agreement effected hereby shall be effective as of the date hereof and, except
as set forth herein, the Rights Agreement shall remain in full force and effect
and shall otherwise be unaffected hereby.

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         4. COUNTERPARTS. The Amendment may be executed in one or more
counterparts shall for all purposes be deemed to be an original and all such
counterparts shall together constitute but one and the same instrument.

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         IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be
duly executed and attested, effective as of the day and year first above
written.

                                            OPHTHALMIC IMAGING SYSTEMS

Attest:

By: /s/ STEVEN C. LAGORIO                   By: /s/ STEVEN R. VERDOONER
    ----------------------                      -----------------------
    Steven C. Lagorio                           Steven R. Verdooner
    Director of Finance                         Chief Executive Officer


                                            AMERICAN SECURITIES TRANSFER, INC.

Attest:

By: /s/ LAURA SISNEROS                      By: /s/ KELLIE GWINN
    ----------------------                      -----------------------
      Title: Vice President                       Title: Senior Vice President
                                         

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