Acute angle-closure glaucoma pathophysiology involves which of the following?

Acute angle-closure glaucoma pathophysiology involves which of the following?

• A. Decreased drainage of aqueous humor via the trabecular meshwork and canal of Schlemm in patients with preexisting narrow angle or large lens
• B. Increased production of aqueous humor by the ciliary body
• C. Inflammation of the iris
• D. Degeneration of the retina

Answer: (A)

Acute angle-closure glaucoma happens when the drainage angle between the iris and cornea closes, causing a rapid drop in the outflow of aqueous humor. In eyes with a preexisting narrow angle or a relatively large lens, dilation or forward movement of the iris blocks the trabecular meshwork and the canal of Schlemm, so aqueous humor cannot drain efficiently. This outflow obstruction is the key driver of the sudden, dangerously high intraocular pressure seen in this condition. This is why the best explanation is decreased drainage through the trabecular meshwork and Schlemm’s canal. Increased production of aqueous humor by the ciliary body would raise pressure only if drainage were adequate; it’s not the mechanism of acute angle-closure. Iris inflammation represents a different process (uveitis) that can affect intraocular pressure in other contexts, not the classic angle-closure pathway. Retinal degeneration is unrelated to the acute blockage of aqueous outflow.

Acute angle-closure glaucoma happens when the drainage angle between the iris and cornea closes, causing a rapid drop in the outflow of aqueous humor. In eyes with a preexisting narrow angle or a relatively large lens, dilation or forward movement of the iris blocks the trabecular meshwork and the canal of Schlemm, so aqueous humor cannot drain efficiently. This outflow obstruction is the key driver of the sudden, dangerously high intraocular pressure seen in this condition.

This is why the best explanation is decreased drainage through the trabecular meshwork and Schlemm’s canal. Increased production of aqueous humor by the ciliary body would raise pressure only if drainage were adequate; it’s not the mechanism of acute angle-closure. Iris inflammation represents a different process (uveitis) that can affect intraocular pressure in other contexts, not the classic angle-closure pathway. Retinal degeneration is unrelated to the acute blockage of aqueous outflow.