Many glaucoma patients continue to lose vision despite treatment to lower intraocular pressure. In addition to the loss of retinal ganglion cells in the eye, there is injury to major visual pathways of the brain along the retino-geniculo-cortical pathway. Evidence for this comes from both glaucoma models and glaucoma patients. Understanding central visual system changes in glaucoma will provide insights into human glaucomatous neural degeneration and disease progression, in addition to potential novel strategies to prevent vision loss in glaucoma.