Glaucoma—a degenerative optic neuropathy—is a leading cause of irreversible blindness. Experts estimate that this neurodegenerative disease will affect 112 million individuals worldwide.1 To date, all available therapies (medical, laser, and surgical) aim at the reduction of intraocular pressure (IOP) and none of the medical therapies aiming at neuroprotection have found much credence. Therapies targeting the degenerating neuronal population have received considerable attention, in particular antioxidant vitamins, not only for glaucoma but also for other neurodegenerative diseases of the eyes. The most promising among these has been niacinamide, along with its precursors. Even though a more thorough assessment of structural and functional endpoints may improve our understanding of its efficacy, there is enough reason to evaluate the molecule further, in the hope of managing the risk of glaucoma, and tailoring treatment for the individual.