Hypothesis: poly-(R)-3-hydroxybutyrate is a major factor in intraocular pressure.

Short chain poly-(R)-3-hydroxybutyrate (cPHB) is a ubiquitous molecule that readily adheres to others, that is covalently added to proteins and that forms, with polyphosphate, ion channels. High levels of cPHB have been implicated in atherosclerosis and in diabetes. Here, we propose a hypothesis in which cPHB adheres to filaments in the extracellular matrix and this raises intraocular pressure. In a corollary, we propose that a positive feedback relationship between cPHB adherence to filaments, raised IOP and filament stretching constitutes a switch.