The macular pigment optical density (MPOD) signifies a vital component of macular well-being and high-resolution visual acuity. MPOD can serve as a reliable biomarker for assessing the retinal defense mechanisms against oxidative stress and the deleterious effects of excessive light exposure. Elevated MPOD levels offer robust protection against the onset and progression of age-related macular degeneration (AMD) a prevalent cause of vision impairment among the elderly population. MPOD's implications in diverse ocular conditions, including diabetic retinopathy and glaucoma, have been explored and indicate a real need for clinical measurement of MPOD. This review looks at the potential of MPOD as a modifiable biomarker influencing the progression and onset of these conditions, particularly in the context of oxidative stress and retinal ischemia. The integration of MPOD measurement into routine eye examinations presents an unparalleled opportunity for early disease detection, precise treatment planning, and longitudinal disease monitoring. Emerging technologies and longitudinal investigations promise to elucidate the dynamic nuances of MPOD in the context of age-related ocular diseases.