Elevated intraocular pressure in glaucoma can injure retinal ganglion cells and trigger the spread of disease to connected target vision structures of the brain. Glaucomatous degeneration has been observed in retrobulbar and intracranial optic nerve, lateral geniculate nucleus, and visual cortex of the brain. Oxidative damage and glutamate toxicity are implicated in transsynaptic central nervous system injury in glaucoma, similar to other neurodegenerative diseases. The perception of glaucoma as a disorder of "visual neurons" within the eye and brain may contribute to understanding progressive disease, and encourage comprehensive treatment strategies to prevent vision loss in glaucoma.