Which corneal characteristic increases the risk of glaucoma in ocular hypertension?

• A. Thinner cornea
• B. Thicker cornea
• C. Normal thickness
• D. Irrelevant

Answer: (A)

Central corneal thickness is a critical factor in glaucoma risk assessment for ocular hypertension. A thinner cornea is associated with a higher chance of progressing to glaucoma. This link comes from two related ideas: first, thinner corneas can cause underestimation of the true intraocular pressure when measured with standard tonometry, so the actual pressure may be higher than it appears, increasing risk. Second, thinner corneas reflect biomechanical properties of the eye that may make the optic nerve more vulnerable to pressure-related damage. Large prospective data show that eyes with thinner corneas convert to glaucoma more often, independent of measured IOP. In contrast, thicker or normal-thickness corneas generally indicate lower risk of progression. Therefore, thinner cornea is the corneal characteristic that increases risk in ocular hypertension.