Abstract: Autophagy is an evolutionarily conserved lysosomal degradation pathway that controls cellular bioenergetics and cytoplasmic quality. Hence, an effective autophagic clearance system is essential for maintaining the normal physiological function of nerve cells. The autophagy pathway plays a key role in regulation of autophagy related signaling pathways impact on the development of diabetic optic neuropathy (DON). It is verified that many metabolic pathways modulate autophagy by positive and negative regulation and it plays a double-edged role in the progression of DON. To elucidate and take advantage of autophagy to manage neurodegeneration in DON is of great importance. (Int Rev Ophthalmol, 2019, 43: 175-179)