The arrangement of the collagen fibrils of the lamina cribrosa was analyzed by using scanning electron microscopy with clinical regard to morphological alterations in cases of glaucoma at different stages. Adult eyes with no apparent pathological changes and specimens from patients with absolute glaucoma were studied. In the lamina cribrosa of nonpathological eyes the collagen fibrils are arranged circularly around the points of passage of axons and vessels. In specimens from glaucoma patients the characteristic circular alignment of the collagen fibrils around the penetrating axons is generally absent. The collagen fibrils are arranged in coarse bundles, showing no preferred alignment. The present study supports a new hypothesis for glaucoma pathogenesis.
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