What is a key risk factor for developing PACG?

A key risk factor for developing primary angle-closure glaucoma (PACG) is indeed short axial length, often associated with hyperopia (farsightedness). This condition leads to a narrower anterior chamber angle, which can obstruct the outflow of aqueous humor from the eye. In individuals with hyperopia, the eye tends to be shorter from the front to the back, precipitating a risk for angle closure as the structures of the eye are more crowded.

As the pupil dilates in low light or under certain conditions, the iris may be pushed toward the lens, further narrowing the angle and potentially leading to an acute rise in intraocular pressure. The anatomical predisposition created by short axial length means that these individuals have a greater likelihood of developing PACG compared to those with normal or longer axial lengths.

In contrast, factors such as age lower than 30 years, male gender dominance, and infrequent eye examinations do not directly correlate with the anatomical changes that present in PACG. While age is a recognized risk factor for developing glaucoma in general, PACG typically occurs more frequently in older adults, not in individuals under 30. Gender can show some variations in prevalence, but both males and females can develop PACG. Lastly, infrequent eye