Hemodialysis generally exerts minimal effects on various ocular parameters. However, a notable reduction in subfoveal choroidal thickness was observed in diabetic and mixed ESRD populations, suggesting increased vulnerability of choroidal tissues in these groups. These findings underscore the importance of regular ophthalmologic monitoring for ESRD patients undergoing HD, particularly those with diabetes. Future research should address existing heterogeneities and explore the long-term ocular implications of repeated HD sessions.