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Gut microbiota and pediatric eye diseases: current insights, mechanistic underpinnings, and future outlook
Gang Chen1, Yulin Zhang2, Yixia Zhang1
1Department of Pediatric Ophthalmology, Dali Bai Autonomous Prefecture Maternal and Child Health Hospital, Dali, China.
Insights
Early gut microbiota disruptions can impact childhood eye development and visual function. This review explores the gut-eye axis connection in pediatric eye diseases, offering insights for early intervention.
Area of Science:
- Microbiome research
- Ophthalmology
- Pediatric health
Background:
- The gut microbiota is crucial for immune, metabolic, and neural functions.
- Gut dysbiosis is linked to adult ophthalmic disorders.
- Childhood is a key period for gut microbial and ocular development.
Purpose of the Study:
- To review the link between gut microbiota and pediatric eye diseases.
- To examine conditions like allergic conjunctivitis, myopia, retinopathy of prematurity, and postoperative inflammation.
- To understand the gut-eye axis in children.
Main Methods:
- Narrative literature review.
- Searched PubMed, Web of Science, Scopus (2000-2025).
- Focused on gut microbiota and pediatric ophthalmic diseases.
Main Results:
- Emerging associations between gut dysbiosis and pediatric eye conditions.
- Identified immune dysregulation, metabolite imbalance, and barrier dysfunction as key pathways.
- Highlighted the gut-eye axis in pediatric populations.
Conclusions:
- Early gut microbiota disruptions may affect long-term ocular health.
- Provides insights into the etiology and management of pediatric eye diseases.
- Supports the need for early intervention and precision management.
Background:
As a core component of the human microecosystem, the gut microbiota modulates systemic immune-inflammatory responses, metabolic homeostasis, and neural signal transmission via the gut-eye axis. Dysbiosis of the gut microbiota has been closely linked to the onset and progression of multiple ophthalmic disorders in adults. Childhood represents a critical window for both gut microbial colonization and maturation, as well as a formative period for ocular development and visual function establishment.
Objective:
This review systematically examines the evidence connecting gut microbiota to several common pediatric ophthalmic diseases, including allergic conjunctivitis, myopia, retinopathy of prematurity, and postoperative inflammation following congenital cataract surgery.
Methods:
We conducted a narrative literature review analyzing the potential mechanisms underlying the gut-eye axis, including immune regulation, microbial metabolite signaling, crosstalk between the intestinal barrier and blood-ocular barrier, and neural pathways. A comprehensive search of PubMed, Web of Science, and Scopus databases was performed for literature published from January 2000 to October 2025 using search terms related to gut microbiota and pediatric ophthalmic diseases. Studies were selected based on clinical relevance and contribution to understanding gut-eye axis interactions in pediatric populations.
Results:
The review identifies emerging associations between gut microbiota dysbiosis and various pediatric ophthalmic conditions, with evidence supporting immune dysregulation, metabolite imbalance, and barrier dysfunction as potential mechanistic pathways.
Conclusion:
Early disruptions to the gut microbiota may exert potential long-term effects on ocular health. This review aims to provide new insights into the etiology, early intervention, and precision management of pediatric ophthalmic diseases.
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