Abstract: Primary angle closure glaucoma (PACG) is a complex multifactorial disease, and heredity plays an important role in its occurrence and development. Anatomical features such as shallow anterior chamber, short eyeball, thick lens, small corneal diameter and hyperopia are important risk factors for the occurrence of PACG, so genes related to these phenotypes become candidate genes for PACG. Extracellular matrix metalloprotease (MMP) gene and MMP regulatory genes (HSP70, eNOS, MTHFR), nanophthalmos related genes (MFRP, PRSS56), axial length and diopter related genes (HGF, MYOC), and anterior chamber depth related gene (ABCC5) may be related to the susceptibility of PACG. However, the mechanisms of these genes are poorly understood. MMP affects the remodeling of the sclera extracellular matrix during eye development, resulting in changes in the ocular axis and refractive errors. Membrane frizzled-related protein (MFRP) is expressed in ciliary body epithelium and retinal pigment epithelium, which is related to scleral growth and differentiation. Up till now, there exists inconsistencies in different ethnic backgrounds of these candidate gene studies due to the small sample size. (Int Rev Ophthalmol, 2020, 44: 170-175)