Glaucomatous optic nerve cupping as an optic neuropathy

Intraocular pressure (IOP), which causes the lamina cribrosa to bulge backward, produces a pressure gradient along the axoplasm of exiting optic nerve axons, and challenges the circulation, interacts with presently unknown physiologic or anatomic factors to harm the optic nerve and causes loss of vision. Present treatment of glaucoma is limited to efforts to lower IOP. Future treatments may be directed at other contributing anatomic or physiologic abnormalities that permit IOP to be harmful, or at some step in the pathway from insult to mortal injury of the axon or cell body.