Hypertrophy of the Eye Focusing Ciliary Muscle in Glaucoma and Beneficial Effect of Nitric Oxide

Abstract

Karan R Aggarwala

Biophysical and biochemical factors influence progression of myopia and glaucoma. Such factors include degree and du- ration of controlled eye focusing, and metabolism that sustains muscular contraction. Autonomic innervations regulate contractile tissue, adjusting the rate of aqueous outflow. Individual variations are compounded by instrument and exam- iner factors, all of which alter repeatability of measured intra-ocular pressure. Drainage of aqueous humor via the al- ternate, uveo-scleral pathway appears to be amenable to agents such as nitric oxide. The modality by which nitric oxide exerts a beneficial effect is by increasing inter-fiber spacing within the ciliary muscle, reducing density, so aqueous can leave the anterior chamber and permeate into venous circulation. It is hoped that future case-control clinical research studies shall deploy dietary and topical agents to reduce ciliary muscle hypertrophy, soon after a suspected diagnosis. Until then, eye doctors are encouraged to assess near focusing stress and prescribe optical compensatory lenses in ac- cordance with accommodative demand, with under-correction of myopia for patients that do not drive moving vehicles. Ultrasound imaging studies of ciliary muscle for various stages of glaucoma appear to be warranted.

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