## 1 Introduction  
Glaucoma is a chronic optic neuropathy characterized by the progressive degeneration of retinal ganglion cells, leading to structural and functional damage to the optic nerve and, ultimately, irreversible vision loss. It is the leading cause of blindness globally, posing a significant public health concern [1]. Recent estimates project that, by 2040, the number of people suffering from glaucoma will reach 111.8 million worldwide, highlighting the pressing need for effective strategies for the prevention, early diagnosis, and management of this condition [2]. While glaucoma encompasses a range of subtypes, including primary open-angle glaucoma (POAG) and angle-closure glaucoma, they share common features such as optic nerve damage and associated visual field defects [3]. The principal goal of glaucoma management is to reduce and stabilize intraocular pressure (IOP), as it remains the only proven strategy to slow disease progression and preserve vision [4]. Advances in pharmacological and surgical interventions, such as topical medications, selective laser trabeculoplasty, and minimally invasive glaucoma surgeries have substantially improved the standard of care for glaucoma patients [5], with topical therapy and selective laser trabeculoplasty considered as the first-line treatment options [6]. However, the increasing prevalence of glaucoma underscores the need for complementary approaches that extend beyond conventional treatments to address modifiable risk factors. Recent years have witnessed growing interest in the potential influence of environmental and lifestyle factors, such as diet and physical activity, on the pathogenesis and progression of glaucoma [7]. Research suggests that modifiable behaviors may offer an adjunctive therapeutic benefit by providing neuroprotection to retinal ganglion cells and contributing to overall ocular health [8]. Among these factors, physical exercise has emerged as a promising area of investigation due to its well-documented systemic health benefits and its potential role in reducing IOP [9; 10; 11]. The regular practice of physical exercise is associated with numerous health benefits, including reduced risks of cardiovascular disease, cancer, osteoporosis, and fall-related injuries, as well as enhanced mental and cognitive function [12]. These positive effects extend to ocular health, with observational and retrospective studies indicating that individuals who engage in regular physical activity are less likely to develop glaucoma or experience its progression [13; 14; 15; 16; 17; 18; 19]. [PERSON] and colleagues [13] examined the link between physical activity levels and the rate of visual field loss in 141 patients with suspected or diagnosed glaucoma. They found that increased walking, more time spent in moderate-to-vigorous physical activity, and reduced sedentary behavior were associated with slower rates of visual field loss. This relationship may be mediated by the ability of physical exercise to induce short-term reductions in IOP, improve ocular blood flow, and exert neuroprotective effects on retinal ganglion cells [10]. Despite these promising findings, the clinical application of exercise as an adjunctive strategy for glaucoma management remains underexplored. Notably, exercise prescription for glaucoma patients or at-risk individuals must be tailored to their specific health conditions to maximize benefits and minimize risks [20]. Collaboration between sports scientists and eye care professionals is essential to develop evidence-based, individualized exercise regimens that address the unique needs of this population [21]. However, no randomized controlled trials have yet systematically evaluated the long-term impact of structured physical exercise programs on glaucoma prevention or disease progression, leaving a significant gap in the literature.