To systematically review Japanese medical literature published between 1890 and 1930 and identify and catalogue previously unrecorded contributions to Neuro-Ophthalmology.

In the late 19th and early 20th centuries, Japan rapidly modernized its medical infrastructure, particularly integrating and building upon German ophthalmological and neurological research. Although this vibrant academic setting spurred significant Japanese contributions to Neuro-Ophthalmology, this contribution has been largely excluded from the standard Western historical narrative of the field.

The literature review identified five prominent Japanese pioneers—whose pioneering works laid the foundation of modern neuro-ophthalmology.

The literature review identified five prominent Japanese pioneers—whose pioneering works laid the foundation of modern neuro-ophthalmology.

1. Jujiro Komoto (1859–1938): Japan’s first Professor of Ophthalmology, authored Textbook of Ophthalmology (late 19th–early 20th century), the first comprehensive Japanese text integrating neuro-ophthalmic principles and serving as a cornerstone for ophthalmic education.

2. Mikito Takayasu (1860–1938): In his 1905 paper on aortitis, identified retinal vascular changes associated with systemic arteritis, later termed Takayasu’s arteritis, linking systemic inflammation to ocular and neurovascular findings.

3. Yoshizo Koyanagi (1880–1954) and Einosuke Harada (1892–1946): Through their 1914 and

1926 papers on Vogt-Koyanagi-Harada (VKH) disease, defined a multisystem neuro ophthalmic inflammatory disorder and advanced early ocular motility assessments.

4. Shinobu Ishihara (1879–1963): Developed the Ishihara color vision test, for color blindness, lasting tool for visual pathway assessment

Collectively, these works established the scientific and educational framework for neuro-ophthalmology worldwide.

This research challenges the prevailing historical perspective by demonstrating that Japanese investigators not only paralleled but, in some instances, preceded Western advancements in lesion localization and surgical management within neuro-ophthalmology. Incorporating these foundational documents is essential for establishing an equitable and complete historical record of Neuro-Ophthalmology.