Which statement best describes the relationship between corneal thickness and glaucoma risk in ocular hypertension?

• A. Thinner cornea increases risk
• B. Thicker cornea increases risk
• C. No relation
• D. Only IOP matters

Answer: (A)

Thinner corneas are linked to a higher risk of progressing from ocular hypertension to glaucoma. This isn’t just about measurement quirks with IOP—although they matter, since thinner corneas can cause underestimation of true IOP with common tonometry—but also about the eye’s biomechanical vulnerability. A thinner central corneal thickness (CCT) tends to reflect a more pliable ocular shell, which can make the optic nerve head more susceptible to IOP-related stress. Large studies, notably the OHTS, showed that CCT is an independent predictor of conversion to glaucoma: the thinner the cornea, the greater the risk, even after accounting for IOP. So the statement that thinner corneas increase risk best captures the relationship in ocular hypertension.