Pilocarpine and other parasympathomimetic medicines constrict the pupil and "pull" on the trabecular meshwork, increasing the flow of aqueous out of the eye.
Pilocarpine contracts the ciliary muscle in open-angle glaucoma, increasing the outflow of aqueous humour and lowering intraocular pressure. Pilocarpine-induced miosis in closed-angle glaucoma widens the angle of the anterior chamber of the eye, allowing aqueous fluid to leave.
Pilocarpine acts on a subtype of muscarinic receptor (M3) located on the iris sphincter muscle, causing the muscle to contract and cause miosis. This effect is crucial in the treatment of various angle-closure glaucomas in the short term.
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