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This article discusses three largely unrecognized aspects related to fluid movement in ocular tissues; namely, a) the dynamic changes in water permeability observed in corneal and conjunctival epithelia under anisotonic conditions; b) the indications that the fluid transport rate exhibited by the ciliary epithelium is insufficient to explain aqueous humor production; and c) the evidence for fluid movement into and out of the lens during accommodation. We have studied each of these subjects in recent years and present an evaluation of our data within the context of the results of others who have also worked on electrolyte and fluid transport in ocular tissues. We propose that 1) the corneal and conjunctival epithelia, with apical aspects naturally exposed to variable tonicities, are capable of regulating their water permeabilities as part of the cell-volume regulatory process, 2) fluid may directly enter the anterior chamber of the eye across the anterior surface of the iris, thereby representing an additional entry pathway for aqueous humor production, and 3) changes in lens volume occur during accommodation, and such changes are best explained by a net influx and efflux of fluid.

These data are consistent with a vasodilator-evoked increase in plasma-like fluid in the AC, which likely accounts for the IOP elevation. The results are discussed with a model for AH dynamics that may be of importance to senior individuals treated for vascular diseases with these compounds.

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