Chronic obstructive pulmonary disease(COPD)is a group of lung diseases characterized by persistent airflow limitation, often accompanied by chronic hypoxia. This chronic hypoxia can lead to structural and functional changes in the walls of blood vessels throughout the body, causing vascular injury and altered vascular reactivity. The retina and choroid are key ocular structures with rich blood supply and are particularly prone to microstructural changes due to ischemia and hypoxia. Optical coherence tomography(OCT), an ideal tool for observing these microstructural changes, serves as a non-invasive method for assessing retinal microstructures and microvascular pathology. Currently, there is a lack of comprehensive reviews summarizing OCT-based morphological changes in the eyes of COPD patients. This paper provides an in-depth review of existing studies on ocular OCT in COPD patients, focusing on structural and blood flow changes in the retina and choroid. The primary goal of this review is to summarize the impact of COPD on ocular microstructures, explore the underlying mechanisms of these morphological changes, and offer new perspectives for assessing eye diseases in COPD patients.