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This review synthesizes evidence on AD-related visual impairments across molecular, cellular, circuit, and cortical levels. We examine the eye\u2013brain pathological relationship as a working framework, noting experimental evidence for brain-to-eye amyloid-\u03b2 (A\u03b2) transport in mouse models and associations between retinal and cerebral pathology in humans, while emphasizing that bidirectional pathological transport has not been established. Structural and functional changes in the retina, optic nerve, and visual cortex are reviewed, alongside white matter damage and posterior cortical atrophy patterns. We evaluate emerging multimodal tools (OCTA, ERG, and hyperspectral imaging) that shift diagnosis toward an integrated \u201cstructure\u2013vessel\u2013function\u201d assessment. We critically examine non-pharmacological interventions, including 40 Hz gamma stimulation and photobiomodulation, discussing their mechanisms, translational challenges, and the dissociation between structural and cognitive outcomes. We propose the visual system as a candidate pathological window, a quantitative monitoring platform, and an investigational intervention entry point in Alzheimer\u2019s disease. However, clinical translation of these applications requires standardized acquisition protocols, prospective longitudinal validation, and robust mechanistic evidence. To advance this agenda, we identify three priorities: multimodal data integration, closed-loop neuromodulation strategies, and methodologically rigorous validation frameworks.<\/jats:p>","DOI":"10.3390\/vision10030050","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T08:14:46Z","timestamp":1785917686000},"page":"50","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Visual System in Alzheimer\u2019s Disease: A Multilevel Review of Pathology, Monitoring, and Intervention"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8910-7965","authenticated-orcid":false,"given":"Yiman","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People\u2019s Hospital, School of Medicine UESTC, University of Electronic Science and Technology of China, No. 2006, Xiyuan Ave., West Hi-Tech Zone, Chengdu 611731, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junyi","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People\u2019s Hospital, School of Medicine UESTC, University of Electronic Science and Technology of China, No. 2006, Xiyuan Ave., West Hi-Tech Zone, Chengdu 611731, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zile","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People\u2019s Hospital, School of Medicine UESTC, University of Electronic Science and Technology of China, No. 2006, Xiyuan Ave., West Hi-Tech Zone, Chengdu 611731, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dezhong","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People\u2019s Hospital, School of Medicine UESTC, University of Electronic Science and Technology of China, No. 2006, Xiyuan Ave., West Hi-Tech Zone, Chengdu 611731, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People\u2019s Hospital, School of Medicine UESTC, University of Electronic Science and Technology of China, No. 2006, Xiyuan Ave., West Hi-Tech Zone, Chengdu 611731, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2209-1452","authenticated-orcid":false,"given":"Ke","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People\u2019s Hospital, School of Medicine UESTC, University of Electronic Science and Technology of China, No. 2006, Xiyuan Ave., West Hi-Tech Zone, Chengdu 611731, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1016\/S0140-6736(20)32205-4","article-title":"Alzheimer\u2019s disease","volume":"397","author":"Scheltens","year":"2021","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1002\/alz.12694","article-title":"Global Estimates on the Number of Persons across the Alzheimer\u2019s Disease Continuum","volume":"19","author":"Gustavsson","year":"2023","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/S0140-6736(15)01124-1","article-title":"Alzheimer\u2019s disease","volume":"388","author":"Scheltens","year":"2016","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"101273","DOI":"10.1016\/j.preteyeres.2024.101273","article-title":"Alzheimer\u2019s Disease Pathophysiology in the Retina","volume":"101","author":"Gaire","year":"2024","journal-title":"Prog. 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