Pathogenesis of Glaucoma - Mechanisms Beyond Elevated Intraocular Pressure (IOP) and the Need for Comprehensive Management

Glaucoma is a complex and multifactorial neurodegenerative disorder primarily characterized by the progressive loss of retinal ganglion cells (RGCs) and their axons, leading to irreversible visual field defects. The most well-known risk factor for glaucoma is elevated intraocular pressure (IOP), but the mechanisms driving glaucomatous damage extend beyond IOP alone. Recent research has revealed that the pathogenesis of glaucoma involves multiple interconnected processes, including mechanical stress from elevated IOP, neurotrophin deprivation, vascular dysfunction, ferroptosis, oxidative stress, ocular inflammation, and excitotoxicity. This article aims to explore these mechanisms and explain why managing glaucoma solely through IOP reduction is insufficient for preventing disease progression. Netra Eye Institute 5001 Hadley Rd, Ste 210, South Plainfield, NJ 07080 (732) 503 9999