Corneal Structural Differences Linked With Glaucoma Subtypes

Eye doctor checking woman's eyes
Clinicians may eventually use corneal features associated with glaucoma to diagnose or monitor congenital glaucoma progression.

Multiple measurable corneal structural differences exist between congenital glaucoma and eyes without glaucoma, and between primary and secondary congenital glaucoma (PCG and SCG, respectively), including corneal width and thickness, according to findings published in Eye & Contact Lens.

Researchers conducted a prospective, case-control study to identify corneal structural differences between patients with congenital glaucoma and healthy controls using quantitative high-frequency ultrasound biomicroscopy (UBM). They evaluated 180 UMB images from 44 eyes of 30 participants, who were stratified into a glaucoma group and a control group, with mean age 5.2±8.0 years. Researchers obtained 21 parameters, and compared corneal measurements in glaucoma subtypes and age-matched controls with significance testing and mixed effects models using statistical analysis.

The analysis identified significant differences between congenital glaucoma cases and controls in 16 of 21 measured parameters including angle-to-angle, central and peripheral corneal thicknesses, scleral integrated pixel density, anterior corneal radius of curvature, and posterior corneal radius of curvature. Significant differences were observed in 8 parameters between primary congenital glaucoma and glaucoma following congenital cataract surgery (GFCCS). Most notably, researchers observed a wider cornea in patients with PCG while a thicker cornea was associated with GFCCS.

Thicker corneas in GFCCS were associated with higher tissue density, while no correlation was noted between thickness and tissue density in PCG.

“The ability to directly quantify changes in the cornea using UBM has potential to improve clinical diagnosis and management of congenital glaucoma,” according to the investigators.

Study limitations include small sample size and the inclusion of multiple etiologies of glaucoma.


Drechsler J, Lee A, Maripudi S, et al. Corneal structural changes in congenital glaucoma. Eye Contact Lens. 2022;48(1):27-32. doi:10.1097/ICL.0000000000000844