Abstract:  Abnormality in trabecular meshwork pathway leads to high intraocular pressure (IOP), which is the most significant risk factor for primary open angle glaucoma (POAG). Pulsatile characterize the aqueous outflow and originates the development of pumping theory. Trabecular meshwork is prestressed elastic tissue sensitive to IOP variation. Trabecular meshwork is the mobile wall of the compressible chamber, Schlemm canal (SC). It links the IOP induced motion to valve-like structure in SC, which cooperates with opening/close of deep scleral plexus of channels. All above factors involve in regulation of IOP. This article introduces the concept of aqueous pumping system and its potentials in clinic. It could provide new perspective for glaucoma specialist to better understand the mechanism of POAG, optimize the treatment and develop new strategies. (Ophthalmol CHN, 2022, 31: 405-412)

Key words:  trabecular meshwork, Schlemm canal, collector channel, primary open angle glaucoma