Diabetic ocular complications, particularly diabetic retinopathy and diabetic macular edema, remain leading causes of vision impairment among patients with type 2 diabetes mellitus. Understanding the prevalence, risk factors, and management strategies is essential for effective prevention and treatment. To systematically review current evidence on the prevalence, pathophysiology, and therapeutic interventions for diabetic ocular complications. A systematic literature search was conducted in PubMed, Scopus, and Web of Science databases using relevant keywords related to diabetic ocular complications. Inclusion criteria encompassed original research, clinical trials, and systematic reviews reporting ocular outcomes in type 2 diabetes. Exclusion criteria included case reports, conference abstracts, and non-English publications. A total of 102 studies were identified; after screening and full-text assessment, 62 studies met the inclusion criteria. Data extraction included study characteristics, participant demographics, interventions, and outcomes. The Cochrane Risk of Bias tool and Newcastle Ottawa Scale were applied to evaluate study quality. Included studies highlighted the high prevalence of diabetic retinopathy and macular edema, with oxidative stress, inflammation, and epigenetic modifications identified as key pathophysiological mechanisms. Therapeutic strategies such as glycemic control, anti-VEGF therapy, laser photocoagulation, and corticosteroids were shown to reduce disease progression and vision loss. Quality assessment indicated moderate to high methodological rigor across the included studies. Diabetic ocular complications remain a significant public health concern. Early detection, stringent glycemic control, and targeted ocular therapies are critical for reducing the burden of vision impairment. Further high-quality longitudinal studies are warranted to refine treatment protocols and elucidate underlying molecular mechanisms.