PurposeTo provide a summary of the research advances on ocular images-based artificial intelligence on systemic diseases.MethodsNarrative literature review.ResultsOcular images-based artificial intelligence has been used in a variety of systemic diseases, including endocrine, cardiovascular, neurological, renal, autoimmune, and hematological diseases, and many others. However, the studies are still at an early stage. The majority of studies have used AI only for diseases diagnosis, and the specific mechanisms linking systemic diseases to ocular images are still unclear. In addition, there are many limitations to the research, such as the number of images, the interpretability of artificial intelligence, rare diseases, and ethical and legal issues.ConclusionWhile ocular images-based artificial intelligence is widely used, the relationship between the eye and the whole body should be more clearly elucidated.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12938-023-01110-1.