[Does corneal ocular "pseudo-hypertension" exist?].

BACKGROUND

The relation between Goldmann applanation tonometry and central corneal thickness (CCT) was evaluated in several studies during the last thirty years. Patients with ocular hypertension were found to have a significantly higher CCT compared with normals and glaucomas.

PATIENTS: To report on two sisters with elevated CCT and ocular hypertension diagnosed by raised intraocular-pressure (IOP) readings on Goldmann applanation tonometry.

RESULTS

In both patients, there were no signs for early functional or morphological glaucomatous changes. Maximum IOP was 30 mm Hg and 26 mm Hg. The corneal pachymetry revealed an increased CCT in both patients (700 and 680 microns, respectively), while corneal morphology was normal.

CONCLUSIONS

Ocular hypertension can be misdiagnosed by too high applanation tonometer readings in patients with markedly elevated CCT. Before the onset of treatment thus, corneal pachymetry should be performed in patients with ocular hypertension to exclude ocular "pseudohypertension" and to avoid unneccessary treatment.