Abstract: The existing understanding of the pathogenesis of primary angle-closure glaucoma(PACG) mainly centers on angle closure. Among them, the anatomical findings are the majority, and the related concepts and views are varied, but the specific relationship with the pathogenesis remains to be explored. This paper focuses on the outflow block of aqueous humor instead of angle closure. According to the concept of the “big posterior chamber” and the view of its combination with the lens-iris diaphragm, all the structures of the aqueous outflow pathway were reexamined and reintegrated to determine the predisposing links of outflow blocks. Furthermore, the anatomical properties of common terms and their connections with the pathophysiological mechanisms were largely sorted out, and the internal unified relationship between different blocking processes and different subtypes of PACG was also established. It is expected to provide a pathophysiological idea for understanding the pathogenesis of PACG. (Ophthalmol CHN, 2021, 30: 333-336)

Key words:  primary angle-closure glaucoma, pathogenesis, pathophysiology