Purpose <p>To reconstruct the events that led to the first published retinal paintings following the invention of the ophthalmoscope, and to highlight their significance for the development of ophthalmic imaging.</p> Methods <p>A historical analysis was performed based on primary sources, including Adrien van Trigt’s doctoral thesis (<i>De Speculo Oculi</i>, 1853), contemporaneous scientific publications, and archival material related to early ophthalmoscopy and retinal illustration.</p> Results <p>Although Hermann von Helmholtz introduced the ophthalmoscope in 1850, no retinal images but descriptrions of what he observed accompanied his original publication. Within 19 months, the first retinal paintings were published by Adrien van Trigt. This achievement resulted from a collaboration between Franciscus Donders, who recognized the need for visual documentation, and the instrument maker Gerhard Epkens, who independently developed a table-mounted ophthalmoscope with improved illumination and stability. This design enabled simultaneous observation and drawing, allowing Van Trigt to produce the first coloured retinal illustrations, including representations of normal fundus anatomy and early depictions of retinal pathology such as retinitis pigmentosa.</p> Conclusion <p>Achieved prior to the advent of retinal photography in1886, the first published retinal paintings represent a pivotal milestone in ophthalmology. They exemplify the interplay between clinical insight, technical innovation, and artistic expertise, and contributed significantly to the development of ophthalmic diagnostics and documentation.</p>