## 2 Background  
### Ocular Pathologies  
Detecting ocular diseases, such as glaucoma, in their early stages enables preventive measures against vascular accidents, another complication of diabetes that contributes to 162,890 deaths, making it a significant global cause of mortality. Diabetes is associated with numerous complications, with the most severe being metabolic issues linked to mortality, such as ketoacidosis resulting from excessively high blood glucose levels (hyperglycemia) or coma due to excessively low blood glucose levels (hypoglycemia). Hyperglycemia leads to vascular complications (angiopathy) at both the macrovascular level (large vessels) and microvascular level (small vessels). Complications affecting small vessels impact the eyes, kidneys, and nerve pathways, while those affecting large vessels impact the heart and lungs, contributing to myocardial diseases and vascular accidents [2]. Diabetes is a chronic metabolic disorder characterized by elevated blood glucose levels resulting from the pancreas's insufficient production of insulin, a hormone secreted by the pancreas that facilitates the body's metabolism of carbohydrates found in food, preventing glucose levels from becoming excessively low (hypoglycemia) or high (hyperglycemia) [2; 3]. Over time, diabetes leads to complications affecting organs such as the heart, kidneys, eyes, blood vessels, and nerves. We will now delve into complications arising from the involvement of small vessels, specifically impacting vision. Various conditions, including diabetic retinopathy, macular edema, cataracts, and glaucoma, can manifest symptoms ranging from blurred vision to blindness. Diabetic Retinopathy. Elevated glucose levels over time can lead to the blockage of tiny blood vessels nonwishing the retina, reducing its blood supply. In the early stage (non-proliferative diabetic retinopathy), vessels do not proli: ferate, and no new vessels form. In advanced stages (proliferative diabetic retinopathy), affected vessels are destroyed, prompting the formation of new, leaky blood vessels affecting the vitreous body. Scar tissue can result in retinal detachment, creating intraocular pressure that damages the optic nerve, leading to glaucoma and eventual blindness [4]. Cataract. A cataract is a clouding of the lens in the eye that affects vision. The lens, which is typically clear, becomes cloudy over time, leading to a gradual decrease in vision. Cataracts are most commonly associated with aging, and they are a natural part of the aging process. However, cataracts can also develop due to other factors such as injury, certain medications, medical conditions (like diabetes), or prolonged exposure to ultraviolet light [5]. Glaucoma represents the degeneration of the optic nerve, progressively leading to blindness over time [6]. As per the World Health Organization (WHO), glaucoma stands as the second most prevalent cause of blindness globally, impacting over 60 million individuals. This condition is incurable and can advance without evident symptoms until the late stages. Early diagnosis is paramount, and effective management through appropriate treatment is vital. Eye alterations encompass a reduction in the number of retinal ganglion cells and the thinning of optic nerve fibers at the retinal nerve level. The typical diagnostic procedures for ocular pathologies involve ophthalmoscopy or fundoscopy, enabling an in-depth examination of the eye's interior, encompassing the retina, optic disc, and choroid. This process entails the application of dilating drops, followed by capturing internal eye images using an ophthalmoscope (Figure 1) [7]. The early detection of ocular diseases through AI holds significant importance for various reasons. Firstly, it contributes to vision preservation by identifying subtle changes indicative of conditions like glaucoma, diabetic retinopathy, and macular degeneration, which often progress unnoticed in their initial stages. This enables timely interventions, preventing or slowing vision loss and maintaining quality of life.