Endurance training as a modulator of eye health: insights from experimental and clinical studies

<ns3:p>Background: Endurance training, defined as sustained aerobic physical activity such as running, cycling, orswimming, is well established for its cardiovascular, metabolic, and neuroprotective benefits. Emerging evidence suggests that these systemic physiological adaptations may also extend tothe ocular system. However, the influence of endurance exercise on ocular physiology and the development or progression of eye diseases remains insufficiently characterized. Giventhe increasing global burden of age-related and metabolic ocular conditions, identifying modifiable lifestyle factors such as exercise is of growing clinical relevance.Aim of the study: To systematically review and synthesize current evidence regarding the influence of endurance training on ocular physiology and the development or progression of common eyediseases. Material and methods: A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science databases. Studies were selected if they evaluated the effects of aerobic exercise on ocular parameters including intraocular pressure, retinal blood flow, tear film stability, and disease outcomes such as diabetic retinopathy, glaucoma, cataract, and age-related maculardegeneration. Both clinical and preclinical studies were included. Results: Endurance training led to measurable improvements in ocular physiology, including a 15–20% increase in tear secretion, 2–5 mm Hg reduction in intraocular pressure, and up to 140% increase in retinal blood flow. Regular exercise also upregulated antioxidant enzymes and BDNF, while reducing proinflammatory cytokines. Epidemiological and clinical studies showed reduced risk or progression of major eye diseases: 30–40% lower prevalence of dry eye disease, up to 50% lower cataract incidence, 10–15% slower myopia progression, reduced glaucoma and AMD risk, and improved glycemic and retinal outcomes in diabetic retinopathy.Conclusions: Endurance training has a multifaceted impact on ocular health, offering potential protective effects against several age-related and metabolic eye conditions. Further longitudinal andmechanistic studies are needed to define safe and effective exercise parameters for ocular health promotion.</ns3:p>