Intraocular pressure (IOP), which causes the lamina cribrosa to bulge
backward, produces a pressure gradient along the axoplasm of exiting o
ptic nerve axons, and challenges the circulation, interacts with prese
ntly unknown physiologic or anatomic factors to harm the optic nerve a
nd causes loss of vision. Present treatment of glaucoma is limited to
efforts to lower IOP. Future treatments may be directed at other contr
ibuting anatomic or physiologic abnormalities that permit IOP to be ha
rmful, or at some step in the pathway from insult to mortal injury of
the axon or cell body. (C) 1997 Wiley-Liss, Inc.