Oculomics: The Eye as a Window to Systemic Health and Precision Medicine

Oculomics represents a paradigm shift in medicine, redefining the eye as a non-invasive window into systemic health rather than merely a target of disease. This emerging interdisciplinary field leverages high-resolution ocular imaging—including fundus photography, optical coherence tomography (OCT), and OCT angiography—along with molecular analysis of ocular biofluids to identify biomarkers of cardiovascular, metabolic, neurodegenerative, renal, and environmental diseases. Grounded in the retina’s shared embryological, neurovascular, and metabolic pathways with the brain and systemic vasculature, oculomics enables the detection of subclinical pathological processes often years before overt clinical manifestations. The integration of artificial intelligence, particularly deep learning, has been instrumental in decoding complex, high-dimensional ocular data, transforming routine eye examinations into scalable platforms for predictive risk stratification and personalized medicine. Unlike prior reviews focused on technological implementation or clinical integration, this work provides a mechanistic, disease-centric synthesis that maps quantitative retinal and tear-fluid biomarkers to underlying systemic pathophysiology, offering a granular blueprint for future translational research. This review synthesizes the biological rationale, key technologies, and disease-specific evidence underpinning oculomics, while critically examining its translational framework—termed “Healthcare from the Eye.” We also address persistent challenges related to standardization, clinical validation, ethical governance, and health system integration. As these barriers are addressed, oculomics is poised to reposition ophthalmology at the forefront of preventive and precision medicine, making routine eye care a gateway to early systemic health assessment and intervention.