Abstract: Glaucoma is a group of neurodegenerative disorders characterized by the progressive loss of retinal ganglion cells (RGCs) and visual field defects. Imbalance in intraocular pressure (IOP) homeostasis is an important risk factor, while RGC damage and optic nerve impairment are the core pathological features. As a mechanosensitive ion channel, Piezo1 is widely expressed in critical ocular tissues and mediates mechanosensory perception and signal transduction. This review systematically summarizes the dual role of the Piezo1 channel in glaucoma pathogenesis, specifically in IOP regulation and RGC apoptosis. We highlight that Piezo1 maintains IOP homeostasis by modulating calcium signaling pathways, extracellular matrix remodeling, and aqueous humor outflow resistance. Conversely, Piezo1 mediates calcium-dependent apoptotic signaling in response to mechanical stress or ischemic insults, thereby contributing to RGC injury. These insights provide a theoretical basis for investigating glaucoma pathogenesis and developing novel interventional strategies. 

Key words: Piezo1, Glaucoma, Intraocular pressure homeostasis, Trabecular meshwork, Optic nerve injury