The syndrome of closed-angle glaucoma

Abstract

Closed-angle glaucoma is the result of two mechanisms acting either separately or in combination: 1. Pupil block creates a greater pressure in the posterior than in the anterior chamber, pushing the iris on to the cornea. 2. Increased trabecular meshwork outflow in the presence of pupil block creates a lower pressure in the anterior chamber than in the posterior, pulling the iris on to the cornea. Three main groups of eyes manifest closed-angle glaucoma: (i) Mechanism (I) is necessary and sufficient, but (2) precludes the development of angle closure. (ii) Mechanism (I) is necessary but insufficient. Mechanism (2) must also be present. (iii) Mechanism (I) is necessary and sufficient but (I) and (2) may combine to produce an acute attack.