OBJECTIVE To examine the correlations of refraction, axial eye length, and posterior eye wall thickness with retinal microcirculation. METHODS In a prospective study, 25 patients with primary open-angle glaucoma, 12 patients with ocular hypertension, and 12 healthy subjects were examined; only one eye of each participant was considered in the analysis. Posterior eye wall thickness and axial eye length were measured with standardized A-scan ultrasonography. Retinal microcirculation temporal to the optic disc was determined by a scanning laser Doppler flowmeter using automatic full-field perfusion image analyzer software. RESULTS In glaucoma patients, temporal retinal mean flow exhibited significant correlation to the eye wall thickness (r = 0.470, P = 0.042), axial eye length (r = -0.570, P = 0.011), and refraction of the eye (r = 0.520, P = 0.022). In glaucomatous eyes, the temporal retinal mean flow was significantly lower than in healthy subjects or in ocular hypertensive patients (P = 0.01). CONCLUSIONS Myopic eyes have longer axial eye length and thinner ocular wall than emmetropic eyes. In glaucoma patients, the longer the axial eye length and the thinner the ocular wall, the more reduced the retinal microcirculation. The reduced microcirculation found in myopic glaucomatous eyes might contribute to the development of glaucomatous damage in these eyes.