Abstract: Early identification of diagnostic biomarkers is essential to reduce the risk of cornea-related visual impairment. Metabolomics is the study of metabolites in the fluids or tissues of organisms resulting from genome-wide or proteomic interactions. Mass spectrometry and nuclear magnetic resonance are now used in corneal, tear and atrial fluid analysis to identify biomarkers associated with corneal diseases. Infectious keratitis-associated metabolites, such as RVD3, 18-HEPE, and 11(12)-EET, reveal mediators associated with the pathogenic phase of the infection. Inflammatory factors (e.g., arachidonic acid and linoleic acid), and upregulation of short-chain organic acids (e.g., citric acid, pyruvic acid, succinic acid, oxaloacetic acid and glutamate), revealed metabolic mechanisms of ocular discomfort and related disorders after soft contact lens wear. Post-corneal refractive surgery-related metabolites such as ascorbic acid, taurine, spermidine,  histidine and arachidonic acid, suggested metabolites primarily associated with inflammation, oxidation, neuroprotection, and regeneration. Upregulated prostaglandin F2α, Prostaglandin A2, 16,16-dimethylprostaglandin E2, and 5-hydroxy eicosatetraenoic acid could help to identify patients with at-risk cone corneas. Upregulation of metabolites such as collagen subtype III, sphingomyelin, and inositol had the potential to be used as a biomarker for diabetic keratopathy. (Int Rev Ophthalmol, 2025, 49:  141-146)

Key words: corneal diseases, metabolomics