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In acute glaucoma the sclera appears to be edematous and slightly thickened. As the disease progresses the sclera becomes denser than normal. The oblique openings passages for the venae vorticosae are said to be narrowed. The openings for the passage of the anterior ciliary vessels are enlarged in many, particularly in advanced cases. Minute herniae at these openings are sometimes present.
Dilatation and tortuosity of the anterior ciliary veins are due apparently to excessive flow of blood through them on account of the abnormally small amount carried off by the venae vorticosae. In the stage of degeneration, ectasae of the sclera occur most frequently near the equator of the globe. Spontaneous rupture may take place. Anterior Chamber. The anterior chamber is shallow, as a rule.
In advanced absolute glaucoma the chorioid may become reduced to a very thin membrane consisting of connective tissue and pigmented cells, scarcely distinguishable even by moderate powers of the microscope. Atrophy is marked in the vicinity of the venae vorticosae. Czermak and Birnbacher describe proliferation of the endothelium of the large veins with contraction and obliteration of their lumen.
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