ArticleAnnals of eye science2026
Ocular immune homeostasis-mechanisms of precise regulation through coordination of the eye, visual system and beyond: a narrative review.
Article in Annals of eye science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Objective: The visual system relies on clarity, organization, and interactivity to allow for sight. While in the past, the eye was thought to be immune-privileged, newer insights reframe this hypothesis. Recent studies demonstrate that the eye relies on a precise regulation of immunosurveillance to function. Here, we aim to highlight the multiple layers of coordination and regulation that allow for ocular immune homeostasis and how this understanding can shape future research and clinical directions. Methods: The PubMed database was utilized to find recent developments in the field of ocular immunology and immune homeostasis. This review covers research in the English language from 1 January 1980 to 20 December 2025. Key Content and Findings: Ocular immune regulation is multilevel, including systems outside the eye itself. Similar to other previously accepted immune-privileged tissues, the eye hosts a variety of tissue-resident immune cells. These cells have proven necessary for the proper development of the eye as well as the activation of a protective immune response to injury and the evolution of ocular pathology. This involves a complex system of immunoregulation aimed at global homeostasis that protects vision integrity when one eye is compromised and can also involve an immune response in the contralateral eye, further evidence of the tight coordination of the visual system. In looking at diseases of immune overactivation, models highlight the involvement of recruited inflammatory cells in the evolution of the disease, including from beyond the eye itself, as occurs in uveitis. When such inflammation occurs, regulatory T cells (Tregs) and macrophages with an immunoregulatory phenotype are necessary for the regulation and recovery of the eye. Additionally, newer studies have also demonstrated a role for the microbiome in ocular health and disease, creating yet another link between systems at play in immunoregulation of the eye. Conclusions: The future holds multiple opportunities for capitalizing on the multiple layers of immune involvement and coordination of the immune system in ocular health and disease to advance treatments and preserve vision. By understanding the interactions of the eye, the visual system and the immune system, targeted therapies can better promote homeostasis and visual recovery.
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