CD4+ T cells play a dual role in both the protection and injury of retinal ganglion cells (RGC), participating in the critical immunopathological processes associated with retinal ischemia reperfusion injury (RIRI). T helper (Th) 1 and Th17 cells drive retinal inflammation by secreting pro-inflammatory cytokines, leading to RGC damage. In contrast, Th2 and regulatory T (Treg) cells secrete anti-inflammatory factors that modulate immune responses and reduce inflammation, thereby playing a crucial role in protecting RGC. However, under certain disease conditions, their roles may be reversed. Additionally, an imbalance between Th1 and Th2 cells, specifically the imbalance in the cytokines they secrete can influence disease progression. Therefore, a deeper understanding of the complex functions of CD4+ T cells and their subsets in both protecting and damaging retinal health is essential for immune-targeted therapies for RIRI.