Are you able to take a month elective at another institution sometime in M3 or early M4 (April or May before application season). I’d go to an institution that publishes a lot, find a mentor, and work with him to publish as much as you can during that month.
Continue working with the PI that you published with originally. Make publishing the number one priority. In my humble opinion, the number of ophtho pubs + strong ophtho letters (which you will get if you work hard and publish with your mentor) > > third year grades (try your best to HP or H, esp IM, surgery, and ophtho). If you can get 4 or 5 + ophtho pubs by the time you apply, you’ll be in amazing shape!
You are already competitive and will match somewhere. This is to take you to the next level and maybe give you a chance at some top programs like Wilmer, Iowa, Wills, Bascom, etc.
Let me know if you have any questions. Good luck mate!