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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\u2013eye axis to the repurposing of advanced nanocarriers to overcome ocular barriers. This framework lays the groundwork for next-generation, etiology-based precision management.<\/jats:p>","DOI":"10.3390\/v18030310","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T16:06:59Z","timestamp":1772467619000},"page":"310","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Role of Viral Infection and Microbial Dysbiosis in Glaucoma: From Pathogenesis to Therapeutic Strategies"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0080-4513","authenticated-orcid":false,"given":"Xiaobo","family":"Wang","sequence":"first","affiliation":[{"name":"Aier Academy of Ophthalmology, Central South University, Changsha 410083, China"},{"name":"Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Glaucoma Diagnosis and Treatment Technology Innovation Center, Changsha Aier Eye Hospital, Changsha 410015, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha 410083, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiawei","family":"Chen","sequence":"additional","affiliation":[{"name":"Aier Academy of Ophthalmology, Central South University, Changsha 410083, China"},{"name":"Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Glaucoma Diagnosis and Treatment Technology Innovation Center, Changsha Aier Eye Hospital, Changsha 410015, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiuling","family":"Huang","sequence":"additional","affiliation":[{"name":"Aier Academy of Ophthalmology, Central South University, Changsha 410083, China"},{"name":"Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Glaucoma Diagnosis and Treatment Technology Innovation Center, Changsha Aier Eye Hospital, Changsha 410015, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3148-1703","authenticated-orcid":false,"given":"Xuanchu","family":"Duan","sequence":"additional","affiliation":[{"name":"Aier Academy of Ophthalmology, Central South University, Changsha 410083, China"},{"name":"Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Glaucoma Diagnosis and Treatment Technology Innovation Center, Changsha Aier Eye Hospital, Changsha 410015, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2392-6661","authenticated-orcid":false,"given":"Wenxiang","family":"Zhu","sequence":"additional","affiliation":[{"name":"Aier Academy of Ophthalmology, Central South University, Changsha 410083, China"},{"name":"Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Glaucoma Diagnosis and Treatment Technology Innovation Center, Changsha Aier Eye Hospital, Changsha 410015, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1038\/s41467-020-20851-4","article-title":"Genome-wide meta-analysis identifies 127 open-angle glaucoma loci with consistent effect across ancestries","volume":"12","author":"Gharahkhani","year":"2021","journal-title":"Nat. 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