Corneal Centre Thickness in the Young

Corneal centre thickness increases from birth and normally reaches adult levels by around 5 to 9 years of age 1.

We know that CCT plays a significant role in glaucoma risk, particularly in adults. The OHTS (Ocular Hypertension Study) found that, for instance, patients with CCT ≤555 µm had a threefold increased risk compared to those with CCT >588 µm 2.

CCT measurements in paediatric glaucoma are even more essential. Children with congenital glaucoma have statistically significantly thicker corneas than non-glaucomatous age and sex-matched subjects 3.

CCT can also be a useful biomarker for growth hormone deficiency in children 4. The CCT is statistically much higher in children with delayed ocular development. Children with intellectual disabilities, especially those with syndromic aetiologies, exhibit higher CCT compared to controls, which may affect IOP measurements.

We all know the value of CCT measurements in glaucoma clinics, corneal clinics, cataract clinics and refractive surgery clinics, for example. However, where children are concerned, the value of a handheld non-contact pachymeter increases significantly. In busy clinics, dealing with young children and the difficulty of instilling anaesthetic eye drops for ultrasound (US) pachymeters, or the issues of getting small children correctly positioned at desktop based diagnostic devices, can be significant.

The PM1 avoids these problems with children and is easy to use and takes little time. The accuracy and reliability are comparable to both US and desktop based pachymeters too. So, as distributors, it may be prudent to focus considerable attention on paediatric ophthalmology / optometry clinics.

Don’t forget, of course, the other important values the PM1 brings.

• Reduced cost compared to ultrasound pachymeters and higher sustainability (as no anaesthetic drops or sterilising wipes are needed).

• Reduced risk of cross infection compared to US pachymeters as no contact with the eye is required with the PM1.

• Disabled access – remember, not all patients can sit at desktop based diagnostic devices.

Summary

Pachymetry is very often included in the measurements and outputs of a range of multi-function diagnostic devices. It can also be undertaken using ultrasound. However, the PM1 Pachymeter is the world’s first handheld, non-contact optical pachymeter. It offers easy and effective access to pachymetry in multiple circumstances where standard methods may be ineffective or inappropriate. As distributors, it’s important that you deliver these unique selling points and key messages to your customers.

Written by Jason Higginbotham - MyopiaFocus.org managing editor and consultant optometrist, BSc (Hons) MCOptom Prof Cert Glau Prof Cert Med Ret Prof Cert LV FBDO MBCLA

References

1. Prost, M., and Oleszczyńska-Prost, E. (2005). Central corneal thickness in children with congenital glaucoma. Klinika Oczna / Acta Ophthalmologica Polonica, 107(3), pp.445-447.

2. Agbato D, Rickford K, Laroche D. Central Corneal Thickness and Glaucoma Risk: The Importance of Corneal Pachymetry in Screening Adults Over 50 and Glaucoma Suspects. Clin Ophthalmol. 2025 Feb 15; 19:563-570.

3. Amini H, Fakhraie G, Abolmaali S, Amini N, Daneshvar R. Central corneal thickness in Iranian congenital glaucoma patients. Middle East Afr J Ophthalmol. 2012 Apr-Jun;19(2):194-8.

4. Parentin F, Pensiero S. Central corneal thickness in children with growth hormone deficiency. Acta Ophthalmol. 2010 Sep;88(6):692-4. doi: 10.1111/j.1755-3768.2009.01519.x. PMID: 19508460.