# The Role of Viral Infection and Microbial Dysbiosis in Glaucoma: From Pathogenesis to Therapeutic Strategies

## TL;DR

This paper reviews how viral infections and gut microbial imbalances might contribute to glaucoma and suggests new treatment strategies.

## Contribution

The paper introduces a novel framework linking viral and microbial factors to glaucoma pathogenesis and proposes targeted therapeutic approaches.

## Key findings

- Viral persistence and microbial dysbiosis may disrupt autophagy and cause immune dysregulation in glaucoma.
- The gut–eye axis could be a target for metabolic restoration in treating glaucoma.
- Advanced nanocarriers may help deliver therapies across ocular barriers.

## Abstract

Glaucoma is a leading cause of irreversible blindness, yet vision loss often progresses despite effective intraocular pressure (IOP) control, suggesting the involvement of non-hydrodynamic mechanisms. This review explores the potential synergistic interaction between viral persistence and microbial dysbiosis in pathogenesis. While acknowledging that current evidence regarding the microbiome is largely associative and derived from small cohorts or animal models, we analyze how these environmental insults may disrupt autophagic flux and induce immune dysregulation to drive chronic neuroinflammation. Furthermore, we explore theoretical therapeutic strategies targeting this distinct pathological nexus, ranging from metabolic restoration of the gut–eye axis to the repurposing of advanced nanocarriers to overcome ocular barriers. This framework lays the groundwork for next-generation, etiology-based precision management.