This result is consistent with data reported by Feng and Qin, suggesting that ER stress affects autophagy through the PI3K/AKT/mTOR signalling pathway.41, 42 Other studies showed that glaucoma medications sustained activation of ER stress in corneal epithelial cells.43 Okumura et al reported abnormal activation of ER stress in corneal endothelial cells isolated from patients with Fuchs' endothelial corneal dystrophy.44 For the first time, our study suggests that there is a link between ER stress and the initiation of autophagy in ocular surface diseases. This evidence concerns the gene AKT1 and glaucoma.