Which of the following is NOT listed as a risk factor signaling treatment for glaucoma suspects with IOP <22?

• A. Sleep Apnea
• B. Very Thin CCT
• C. Diabetes Mellitus
• D. Strong FHx

Answer: (C)

When deciding treatment for glaucoma suspects with IOP below 22, the main idea is to identify factors that increase the likelihood of progression to glaucomatous damage despite normal IOP. Very thin central corneal thickness makes the eye more susceptible to damage and also can cause underestimation of true IOP, so it flags a higher risk and strengthens the case for intervention. Sleep apnea is linked to vascular factors and optic nerve vulnerability, which can accelerate progression, so it’s another signal to consider treatment. A strong family history indicates a genetic predisposition to glaucoma, increasing overall risk and tilting decisions toward treatment or closer monitoring.

Diabetes mellitus, while it can influence ocular health in various ways, is not a consistently reliable standalone signal for initiating treatment in glaucoma suspects with IOP under 22. The evidence linking diabetes to progression in this specific context is less robust, so it isn’t typically used as a primary trigger for treatment.