Glaucoma is the leading cause of irreversible blindness worldwide and remains a worldwide problem. Epidemiological studies have shown that aerobic exercise, as a noninvasive and low-cost intervention, can effectively reduce the risk of glaucoma by reducing Retinal ganglion cell (RGC) apoptosis. In addition, exercise also exerts neuroprotective effects by reducing inflammation and oxidative stress, upregulating neurotrophic factors and mitochondrial function.

To further analyze the relationship between exercise and glaucoma, the literature was searched through PubMed and Web of Science with the following keywords: “physical activity”, “exercise”, “glaucoma”, and “retinal disease”. All articles published between 1970 and 2022 and their references were retrieved. The focus was to analyze the neuroprotective mechanism of aerobic exercise in reducing the risk of glaucoma by reviewing relevant literature, and to lay a foundation for promoting and advocating aerobic exercise to  reduce the risk of glaucoma.

Apoptosis is the main death mechanism of RGC in glaucoma. The pathological mechanisms of RGC injury include increased inflammation, impaired neurotrophic factor transmission, mitochondrial dysfunction, and oxidative stress. Aerobic exercise can reduce vision loss in glaucoma patients by reducing RGC injury. Moderate-intensity aerobic exercise at least three times a week, within the guidelines recommended by physical activity guidelines, may reduce the risk of glaucoma.

Aerobic exercise plays a neuroprotective role by reducing RGC apoptosis to reduce the risk of glaucoma. Therefore, aerobic exercise is recommended as an intervention to prevent and reduce the risk of glaucoma.