The aim of this systematic review was to evaluate eye illnesses in Para athletes in the Winter and Summer settings. A search was conducted using PubMed-Medline, EbscoHost, and Web of Science for full-text original research articles published anytime until November 2022. Studies that reported quantitative data on eye illness in highly active individuals and Para athletes, at any level of performance (elite/non-elite/recreational), aged 15-75 years were included. Of the eight studies included, two reported eye pathologies in athletes with visual impairment (VI) only, and six studies reported specific factors associated with eye illnesses in various impairments. Illnesses in the eye and adnexa were more prevalent in Winter (incidence: 1.6-2.2/1000 athlete days) compared to Summer (incidence: 0.3-0.5/1000 athlete days) settings. Eye illnesses were reported in athletes with limb deficiency (33.5%), spinal cord injury (29.4%), VI (10.6%), and central neurologic impairment (15.2%). The findings of this review indicate that: 1) Eye illness in Para athletes is an understudied area; and 2) Eye illnesses are present in athletes with impairments other than VI. There is a need for further research on eye illness, particularly in Winter sports settings to understand the types and nature of eye illness affecting Para athletes during competition and training settings.