Please appreciate that, in order to explain this clearly, I have deliberately presented a black and white picture of things. Life is not quite as simple so you need to use this information and then be prepared to have it ‘adjusted’ by your expert to fit the status of your own situation. OK here we go.

Firstly you need to have a concept of the basic anatomy and flow in the normal eye. Please watch this YouTube video clip.













Think of the ciliary body as a tap producing liquid into the eye and the trabecular meshwork as the plughole out of which the fluid drains.

​Anatomical changes 

Eyes, like humans, come in all sorts of shapes and sizes. For example short sighted eyes tend to be long and long sighted eyes short…..a bit paradoxical! The shape of the eye can alter the drainage flow within the eye. This diagram shows how the shortening of the eye can change the drainage.













Ageing changes 
As we age the eye changes. In particular the lens in the eye continues to grow. This is because embryonically it is derived from the layer that makes the skin. Most of this growth happens backwards into the main cavity of the eye, however some happens forwards narrowing the drainage angle.

The following YouTube video does a pretty good job of describing the methods of treating angle closure.

If the pupil semi-dilates so the edge of the iris is touching the lens

Angle closure (this is being written at present so is not complete and will be updated)

It can stick to the lens like a wet plate upside down on a flat surface means the fluid can't get through and the iris is pushed forwards blocking the drainage angle. The pressure inside the eye then rockets up causing acute angle closure.

Acute angle closure
If your angle is narrow then under normal conditions then the fluid in the front of the eye flows normally. 

Anatomy and ageing combined 
If you start life with a shorter eye then the narrow angle will become more narrow with time. This typically reaches a point of possible concern after the age or forty or fifty years. For some reason this is more often a problem in females.

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MSc MD FRCOphth​​ FWACS MBE

​Glaucoma Consultant Surgeon

Moorfields, London