The cornea is a transparent tissue essential for maintaining ocular refractive function and visual quality. Corneal injury and disease remain major causes of visual impairment and blindness. However, conventional pharmacological therapies and corneal transplantation are still limited by immune rejection, donor tissue shortage, and suboptimal long-term outcomes. Exosomes, a subtype of extracellular vesicles(EVs)secreted by various cell types, are enriched in bioactive molecules such as proteins, lipids, mRNA, and miRNA. Owing to their low immunogenicity, favorable biocompatibility, capacity to stably deliver key signaling molecules involved in inflammation regulation and tissue repair, and suitability for local corneal administration, exosomes partially overcome the limitations of traditional corneal therapies in terms of precise immunomodulation and repair efficiency, thereby demonstrating considerable research value. This review systematically summarizes the biological characteristics of exosomes and recent advances in the application of exosomes derived from different sources in corneal injury repair, inflammation and immune regulation, and related corneal diseases, with a particular focus on their underlying mechanisms and therapeutic potential, aiming to provide a reference for standardized research and clinical translation of exosome-based therapies in corneal diseases.