Physiological and Biomechanical Aspects of Aqueous Humor Flow in Glaucoma

Abstract

Glaucoma is a progressive optic neuropathy characterized by irreversible vision loss and is one of the leading causes of blindness worldwide. Elevated intraocular pressure (IOP), primarily governed by the production and drainage of aqueous humor, remains the most significant modifiable risk factor in glaucoma management. Understanding the dynamics of aqueous humor flow is therefore central to elucidating the pathophysiology of glaucoma. This review presents a comprehensive analysis of aqueous humor formation, circulation, and outflow mechanisms under normal and glaucomatous conditions. Emphasis is placed on the biomechanical, hydrodynamic, and molecular alterations that impair aqueous humor drainage, particularly in the trabecular meshwork and uveoscleral pathways. Advances in experimental studies, imaging techniques, computational fluid dynamics (CFD), and mathematical modeling of aqueous humor flow are critically reviewed. The paper also discusses therapeutic implications and future research directions integrating biomechanics, nanotechnology, and personalized medicine.