Glaucoma remains the leading cause of irreversible blindness worldwide. Despite clinical advancements in managing intraocular pressure, a significant subset of patients experiences persistent neurodegeneration and vision loss. This Stanford Bio-X Interdisciplinary Initiatives Seed Grant project addresses this clinical gap by shifting focus from the eye alone to the entire visual pathway’s metabolic waste clearance network. Our research investigates the hypothesis that impaired fluid dynamics — specifically involving cerebrospinal fluid and aquaporin-4 water channels in the brain-eye axis — disrupts the clearance mechanism of toxic substances, leading to optic nerve damage. By using highfield, multi-parametric magnetic resonance imaging, our team will identify early pathophysiological events that remain invisible to traditional ophthalmic exams. Furthermore, we will evaluate the efficacy of cutting-edge, non-invasive interventions, such as ultrasound modulation and targeted drug therapies, to restore drainage function and halt neurodegeneration. This new collaboration between Stanford Ophthalmology and Radiology integrates expertise in neurobiology, imaging, and bioengineering. By uncovering the interplay between ocular and cerebral drainage systems, this study seeks to establish a new paradigm in glaucoma care. Ultimately, our goal is to develop clinically translatable treatments that protect the full visual pathway, offering hope to patients whose disease progresses despite controlled eye pressure.