Corneal thickness in glaucoma screening, diagnosis, and management.

PURPOSE OF REVIEW: Variability in central corneal thickness (CCT) is a potent confounder of most tonometry techniques, especially Goldmann applanation tonometry. The Ocular Hypertension Treatment Study (OHTS) provided important information regarding predictive factors for the eventual development of glaucoma in patients at risk of the disease. Among the most striking of the OHTS' findings was that CCT was a powerful predictor of glaucoma risk. In this review, studies subsequent to the OHTS report will be reviewed and placed in the context of what is known about CCT and its relation with tonometry and glaucoma risk.

RECENT FINDINGS: Several well-designed studies have since expanded on this hypothesis, confirming that CCT bears an inverse relation with the risk of developing glaucoma damage. Other investigators have confirmed the presence of racial differences in CCT and pilot studies suggest that CCT may vary systematically in different forms of glaucoma.

SUMMARY: The absence of a widely-accepted algorithm for the correction of IOP measurements should not prevent the widespread adoption of pachymetry as part of the comprehensive eye exam, as knowledge of an individual's CCT provides valuable information about their glaucoma risk.