Twenty patients with early chronic closed-angle glaucoma were studied. Closure of the angle on gonioscopic examination was differentiated into areas of (a) iridotrabecular contact or (b) goniosynechiae, because pilocarpine resolved a. Areas of closed angle are found most commonly in the superior angle, and the incidence diminished progressively inferiorly. Pilocarpine hydrochloride-induced resolution of iridotrabecular contact occurs most often inferiorly and least often superiorly, with nasal and temporal quadrants intermediate. Accordingly, angle closure probably develops insidiously from above downwards (which may well also apply to subacute and acute cases) at first by reversible iridotrabecular contact and later by permanent goniosynechiae.
Ocular tension was directly related to the extent of the angle closed (r =+0.456;.01 <P<.05) before pilocarpine therapy was given.
Bhargava SK, Leighton DA, Phillips CI. Early Angle-Closure GlaucomaDistribution of Iridotrabecular Contact and Response to Pilocarpine. Arch Ophthalmol. 1973;89(5):369-372. doi:10.1001/archopht.1973.01000040371003