Central Corneal Thickness and Glaucoma Risk: The Importance of Corneal Pachymetry in Screening Adults Over 50 and Glaucoma Suspects

Glaucoma is a leading cause of preventable blindness, yet nearly half of those affected are unaware of their diagnosis. Individuals with glaucoma may present with “normal” or “lower” intraocular pressure (IOP) compared to typical glaucoma thresholds, due in large part to many of these individuals having thin corneas. Conversely, many with elevated IOP and thicker corneas may not necessarily have glaucoma. In this article, we review the importance of central corneal thickness (CCT) and corneal pachymetry devices in eye care. Additionally, we review the role of corneal thickness as a risk factor for glaucoma and glaucoma progression. PubMed and Web of Science databases were searched for articles and reviews on corneal pachymetry and its use in glaucoma, corneal biomechanics and refractive surgery, and glaucoma screening. The results of this review revealed that CCT is a risk factor for development of glaucoma, and in eyes suspected of glaucoma, corneal pachymetry can be performed by trained technicians to provide important information related to the risk of acquiring glaucoma and/or having other ocular diseases. Additionally, a lower CCT is associated with an increased risk of progression and faster rates of visual field loss in eyes with glaucoma. This review will provide evidence regarding the importance of performing corneal pachymetry on all persons over the age of 50 as part of a comprehensive eye examination to better identify those patients who have glaucoma or are glaucoma suspects.