Czermak states that the flattening of the anterior chamber usually attributed to glaucoma really exists before the glaucoma, and predisposes to it. The flattening of the chamber he explains as being an excessive degree of the physiological flattening of old age, which is due to a diminished secretion of aqueous humor from the secretory parts, which have undergone senile degenerative changes.
In cases of acute glaucoma there is no inflammatory adhesion between the iris and the ligamentum pectinatum. This condition is brought about, according to Czermak, as follows. In consequence of an excessive dilatation of the pupil when the chamber is shallow, the periphery of the iris becomes thickened until it touches the margin of Descemet's membrane.