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Exposome for Ocular Diseases: From Exposure Evidence to Causality and Actionable Prevention
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Your eyes are constantly exposed to environmental stressors, air pollution, harsh weather, heavy metals, and even tiny plastic particles, and this review pulls together existing research showing how these exposures can contribute to eye problems ranging from dry eye to cataracts, glaucoma, and retinal disease. The takeaway: eye health isn't just about genetics or aging, what's in your air, water, and surroundings matters too, and understanding these links can help guide prevention strategies and policies to protect your vision over your lifetime.
The exposome, defined as the totality of external exposures individuals experience throughout the lifespan and the internal biological responses they trigger, is increasingly recognized as a major, modifiable determinant of health. The eye is uniquely vulnerable to exposome risk factors because it comprises an external interface directly exposed to the environment, a transparent lens highly sensitive to cumulative oxidative injury, and metabolically active retina prone to inflammation and vascular dysregulation. Research linking ocular diseases to air pollution, climate and weather factors, heavy metals, persistent organic pollutants, and emerging threats such as micro-/nanoplastics has expanded rapidly, yet the evidence remains fragmented and lacks systematic integration. In this review, we propose an anatomy-informed ocular exposome atlas along the visual axis to comprehensively evaluate evidence from clinical studies, pathological mechanisms, and intervention strategies across major disease groups-including ocular surface diseases, cataract, refractive errors, glaucoma, and retinal diseases. We further integrate cross-disease mechanistic pathways (oxidative stress, cellular responses, inflammation, immune reactions) and discuss causality. Finally, we identify priority research directions and provide actionable recommendations for prevention and policy.
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This research review shows that common environmental pollutants like cigarette smoke, UV rays, heavy metals, and even microplastics can damage the cells in your eyes and contribute to serious vision problems like macular degeneration and glaucoma. Your eyes are especially vulnerable to this damage because they use a lot of energy and are constantly exposed to light and oxygen. Understanding how these everyday exposures harm our vision could help doctors develop better treatments and prevention strategies for eye diseases.
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This review examines how micro- and nanoplastics may enter and affect the human eye, a topic that has received relatively little research attention. Researchers discuss potential exposure pathways, accumulation in ocular tissues, and mechanisms of harm including oxidative stress, inflammation, and cell death. The study highlights the need for more research on how plastic pollution could impact vision and overall eye health.
Toxicology research on the effects of environmental pollutants on the retina: A review
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Researchers reviewed how environmental pollutants — including heavy metals, industrial chemicals, and microplastics — damage the retina (the light-sensing tissue at the back of the eye), finding that oxidative stress is the core mechanism and that the developing retina is especially vulnerable. The review provides a foundation for understanding how long-term environmental exposure could contribute to vision problems and eye disease.
Impact of Microplastics on the Ocular Surface
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This review examines emerging evidence on how microplastics may affect the surface of the human eye. Researchers found that microplastics can potentially trigger inflammatory responses, microbial imbalance, and oxidative stress in ocular tissues, though research is still limited. The study highlights the need for more investigation into this overlooked exposure route, as the eyes are constantly exposed to airborne particles including microplastics.
Identification of microplastics in human tear fluid and meibum: Implications for dry eye disease pathogenesis
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For the first time, researchers confirmed the presence of microplastics in human tear fluid and the oily secretions of the eyelid glands (meibum), with polyethylene being the most common type found. Higher polyethylene levels correlated with worse dry eye disease symptoms. In lab and mouse experiments, polyethylene exposure damaged eye surface cells and triggered inflammation, suggesting airborne microplastics may contribute to dry eye disease.
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