Immune-mediated eye diseases(IMED)represent a kind of autoimmune eye diseases, such as thyroid-associated ophthalmopathy, autoimmune uveitis and Sjögren syndromes. Owning to its complicated pathophysiological mechanisms, the efficacies of current therapeutic strategies for IMED are unsatisfactory, which may ultimately result in severe visual impairment. Exosomes are lipid bilayer vesicles secreted by cells that play an important role in cell-to-cell communication and immune regulation. Recent studies have shown that exosomes secreted by cells under pathological conditions are closely associated with the development and progression of IMED, and the exosomes derived from certain cells(such as mesenchymal stem cells)are deemed as promising therapy for IMED. Hence, we review the recent advances of exosomes in IMED.