Which action do cholinergic agonists like pilocarpine take to reduce IOP?

Cholinergic agonists, such as pilocarpine, effectively reduce intraocular pressure (IOP) primarily by increasing corneoscleral outflow. These agents stimulate the muscarinic receptors in the eye, leading to contraction of the ciliary muscle. This contraction results in a widening of the trabecular meshwork and decreases resistance to aqueous humor flow through the conventional outflow pathway. Consequently, more aqueous humor is able to exit the eye, which lowers IOP.

While it's important to note how these medications act on other aspects of ocular physiology, their primary mechanism related to IOP reduction is through enhancing the outflow of aqueous humor. This is crucial in managing conditions such as glaucoma, where elevated IOP can lead to optic nerve damage. Understanding the specific pathway through which cholinergic agonists operate helps clarify their role in treating this condition effectively.