Hypothesis: Watershed zones in the human eye are a key for understanding glaucomatous retinal damage

The pathogenesis of glaucoma is complex which has led to numerous hypothesizes concerning the important factors creating this specific type of inner retinal degeneration namely apoptosis of retinal ganglion cells. We favor a primary vascular etiology and provide evidence that the pathogenesis of glaucoma should not be confined to changes exclusively at the optic nerve head but must include changes occurring in the peripheral retina with particular emphasis on the watershed zones of both the retina and choroid. This focus may help to sharpen ones awareness for early glaucoma treatment particularly in patients with minimal findings suggestive of glaucoma.