Abstract: The ciliary body and its adjacent anatomical structures play a vital role in the pathogenesis of primary angle closure glaucoma (PACG). With the development of anterior segment imaging techniques such as ultrasound biomicroscopy, the key roles of pathogenic mechanisms including ciliary body rotation, narrow cilio-lenticular space, and zonular abnormalities in PACG have been gradually revealed. This article reviews the dynamic changes in ciliary body morphological parameters during the occurrence and progression of the disease. Based on the "trans-lens pressure differential" hypothesis, it proposes that morphological abnormalities of the ciliary body and zonules are downstream biomechanical outcomes of abnormally elevated trans-lens pressure differential: specifically, the pathological process progresses from initial ciliary block and the formation of trans-lens pressure differential to anterior lens displacement and forced stretching of the ciliary body, which further results in mechanical decompensation of the zonules. The above mechanisms contribute to a deeper understanding of the multifactorial pathogenic network of PACG and provide a new theoretical basis for fundamentally relieving ciliary block and improving patient prognosis by reshaping ciliary process morphology.

Key words: Angle closure glaucoma, Ciliary body, Trans-lens pressure differential