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They may be briefly classified as: 1. Those that cause a partial or complete closure of the lymph spaces and Schlemm's canal by cicatrical contraction, as in sclero-keratitis. Those that cause obstruction to the lymph spaces at the filtration angle by the deposition of fibrin or cellular elements, as in iritis, hemorrhage into the anterior chamber, etc.
Treacher Collins found, after a careful examination of eyes upon which iridectomy had been performed for glaucoma, that it is extremely rare for the initial section to pass through the pectinate ligament, while Schlemm's canal invariably escapes.
It is in such cases that the success of the operation is increased by the addition of posterior sclerotomy and the intelligent use of miotics prior to the performance of the iridectomy. Even then the permanent results of the iridectomy will be modified in proportion to the success secured in freeing the filtration angle and opening Schlemm's canal by thorough removal of the root of the iris.
Any process that increases the volume of the contents of the vitreous chamber, as hemorrhage, neoplasm, profuse serous or plastic exudation, may by pushing iris and lens forward produce an attack of acute glaucoma. Buphthalmos. Ophth. In all of the cases in which the eye has been examined microscopically obliteration of Schlemm's canal has been reported.
Obstruction to the steady escape of the intra-ocular fluids at any point in this drainage system or any undue increase of the fluids themselves may produce glaucoma. Probably the most important obstruction to the exosmosis is at the angle close to Schlemm's canal."
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