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A systematic review of main physical effects generated by ion exchange in silicate glasses is presented. Ion concentration distributions, residual stress profiles, and refractive index effects are discussed with particular attention on the physical and mathematical underpinnings of the ion exchange process. The study has the purpose of presenting a scientific foundation to enable future developments in the field. In this respect, the objective of this article is more educational than to present new research results. Appendixes are included to consider the detail of some specific topics without disrupting the continuity of the overall discussion. Despite the review approach of this study, some original topics are included, such as the concentration distribution with variable boundary conditions and residual stress profile with anomalies due to different relaxation mechanisms, viz., either isochoric and non-isochoric and stress driven or free energy driven. The time scale of the different relaxation mechanisms results, for some specific glass chemical compositions, in the appearance of a subsurface compression maximum progressively moving apart from glass surface and eventually turning in a reversal from compression into tensile state upon prolonged ion exchange processes. Finally, a broad discussion on optical effects induced by ion exchange is presented, paying particular attention to the possibility of experimental determination of residual stress profile.