Evolution of Oculomics: From Naked Eye Observations to Artificial Intelligence over 100 Years

Purpose: To provide a historical review tracing the evolution of oculomics, the study of ocular biomarkers of systemic disease, from early clinical observations to the emergence of advanced imaging and artificial intelligence (AI) technologies over the last century. Design: Narrative historical review. Subjects: Not applicable. Methods: A review of key historical and technological developments in ocular examination, imaging, and data analysis that have shaped the modern field of oculomics. Main Outcome Measures: Not applicable. Results: The central concept underlying oculomics-the eye being a uniquely accessible site for detecting systemic disease-has long been recognized in clinical practice. Over the past century, advances in imaging and computational methods have enabled increasingly precise quantitative measurements of retinal biomarkers able to detect cardiovascular, neurodegenerative, and metabolic diseases. Recent integration of AI-based image analysis has further expanded research and diagnostic potential. Conclusions: Oculomics, while recently formalized as a defined field, represents the convergence of historical clinical insights with modern technological innovation. By situating current advances within a broader historical context, this review highlights the way in which the role of the eye in systemic disease detection has evolved over the last century. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.