Related Experiment Video
Updated: Jun 19, 2026

Trabecular Meshwork Response to Pressure Elevation in the Living Human Eye
Published on: June 20, 2015
Angle-closure glaucoma-simpler answers to complex mechanisms: LXVI Edward Jackson Memorial Lecture
1Glaucoma Service and Dana Center for Preventive Ophthalmology, Wilmer Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. hquigley@jhmi.edu
Purpose:
To present evidence-based concepts that will explain mechanisms of angle-closure glaucoma.
Design:
Review of published evidence and personal perspective.
Methods:
Literature review and clinical research using imaging devices.
Results:
When the pupil dilates, the iris typically decreases its volume by losing extracellular fluid. Eyes with angle-closure lose less iris volume with pupil dilation, contributing to obstruction of the trabecular meshwork. Expansion of choroidal volume is a dynamic phenomenon and is a major risk factor in angle-closure. The mechanism of malignant glaucoma seems likely to result from poor conductivity of fluid through the vitreous, and past suggestions that it results from "misdirected" aqueous are not consistent with physiological principles.
Conclusions:
Angle-closure and angle-closure glaucoma result from disturbed physiological mechanisms more than from simple anatomic measures, and future predictive testing can exploit knowledge of these factors.
Related Concept Videos
Glaucoma: Overview
Angle Closure Glaucoma: Treatment
Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
Mechanism of Ciliary Motion
The cilia are made up of microtubules in a 9+2 arrangement, with nine microtubule doublet ring bundles, surrounding a pair of central singlet microtubule bundles. The doublet microtubule bundles are...
Mechanism of Ciliary Motion
The cilia are made up of microtubules in a 9+2 arrangement, with nine microtubule doublet ring bundles, surrounding a pair of central singlet microtubule bundles. The doublet microtubule bundles are...

