Central corneal thickness in children—does it help or hinder our evaluation of eyes at risk for glaucoma?

Abstract

lmology a Central corneal thickness (CCT), now measured on every adult with suspected glaucoma, was initially considered imp cause it affected the accuracy of measured pressure (IOP) by Goldmann applanation t Thicker central cornea, it was thought, resulted elevated measured IOP because of the assum thickness underlying the formulas used in Gol planation tonometry. The “simple” solution fo corneal thickness seemed to be a nomogram fo the measured IOP to obtain the “true” IOP. N A number of well-designed, prospective, rando ical trials in adults have demonstrated that there CCT than simple nomograms can explicate. C important predictive factor for the developme coma among participants in the Ocular H Treatment Study. Furthermore, lower CCT in risk of developing glaucoma in a measured OHTS Glaucoma Prevention study. Finally, in a recentl Early Manifest Glaucoma Trial study, lower C significant risk factor for progression of glaucoma with higher baseline IOP. Since IOP was no criterion for this last study, CCT may play a ro mining glaucoma risk that outstrips its influence o IOP by Goldmann applanation tonometry, espe the IOP is higher. At lower IOP, glaucoma ri may be dominated by factors other than IOP. While the exciting story of CCT in adults u are just beginning to examine this feature in e dren. The average CCT of normal children is that of adults, and there is little reported e on CCT. As in adults, race seems to affect avera normal eyes—hence average CCT appears to b normal black children than in normal white Among normal children without glaucoma, there lation between thicker CCT and higher measur Goldmann applanation and tonopen tonometry, there is no study where the true IOP was measur