<p>Health disparities among different racial groups have been a persistent issue in healthcare, as individuals from marginalised racial groups often experience reduced access to quality healthcare services and are frequently underrepresented in research, especially in clinical trials. This underrepresentation is rather evident in ophthalmology, where conditions like open-angle glaucoma and diabetic macular oedema disproportionately affect racial and ethnic minority patients. Despite the higher disease burden, historically marginalised minority groups are less likely to be enrolled in clinical trials, which may hinder the advancement of medical knowledge and the development of effective treatments for these populations. This narrative review provides a comprehensive overview of the potential barriers to ophthalmology clinical trial participation among racial minorities reported in the current literature, including institutional barriers, cultural and linguistic barriers, public awareness, structural barriers, and researcher and physician bias. By identifying and addressing these barriers, we aim to promote equitable representation in ophthalmology clinical trials and ensure that advancements in medical research benefit all racial and ethnic groups.</p>