Which mechanism is primarily responsible for the effect of Pilocarpine in the treatment of glaucoma?

Pilocarpine is a muscarinic cholinergic agonist that primarily acts to lower intraocular pressure in patients with glaucoma by enhancing corneoscleral outflow. This mechanism involves stimulating the contraction of the ciliary muscle, which leads to a widening of the trabecular meshwork's passages and increases the outflow of aqueous humor through the conventional outflow pathway.

As the ciliary muscle contracts, it alters the shape of the trabecular meshwork, thereby reducing resistance to aqueous outflow. This results not only in lower intraocular pressure but also in improved drainage of the fluid produced within the eye. By promoting this outflow through the corneoscleral route, pilocarpine effectively helps manage the symptoms of glaucoma.

While other options involve different mechanisms of action, they do not directly pertain to the primary effects of pilocarpine. Increasing uveoscleral outflow or decreasing aqueous humor production are not the primary actions associated with pilocarpine. Additionally, increased systemic circulation is unrelated to the local effects of pilocarpine in the eye. Understanding the distinct mechanism of corneoscleral outflow enhancement clarifies why pilocarpine is effective in alleviating elevated intraocular pressure in