More doctors are employing new methods of glaucoma management and monitoring to develop a broader picture of a patient’s ocular health beyond intraocular pressure (IOP) measurements. On the list of new management tools is corneal hysteresis (CH), which quantifies the difference between the pressure at which the cornea bends inward and the pressure at which it bends back out. Proponents believe this difference can help illuminate a glaucoma patient’s or suspect’s risk of disease progression—with low hysteresis indicating greater risk. While research bears out this hypothesis, researchers note, it’s important to take several factors into account.1

According to a newly published report, CH is significantly associated with factors other than glaucoma, such as age, sex and ethnicity. Investigators warn to take these into account when interpreting CH values.2

British investigators looked into the records of 93,345 patients who’ve had their CH measured. The mean CH was 10.6mm Hg (10.4mm Hg in males and 10.8mm Hg in females). After adjusting for covariables, CH was significantly negatively associated with male sex, age, Black ethnicity, self-reported glaucoma, diastolic blood pressure and height. CH was significantly positively associated with smoking, hyperopia, diabetes, systemic lupus erythematosus (SLE), greater deprivation and Goldmann-correlated IOPs. Self-reported glaucoma and CH were significantly associated when CH was less than 10.1mm Hg after adjusting for covariables. When CH exceeded 10.1mm Hg, the researchers found no significant association between CH and self-reported glaucoma.2

The researchers indicate that CH may serve as a biomarker aiding glaucoma case detection, but warn that these other factors can contribute to the measurement as well. 

1. De Moraes C, Hill V, Tello C, et al. Lower corneal hysteresis is associated with more rapid glaucomatous visual field progression. J Glaucoma. 2012;21:4:209-13.

2. Zhang B, Shweikh Y, Khawaja A, et al. Associations with corneal hysteresis in a population cohort: Results from 96,010 UK Biobank participants. Ophthalmol. July 5, 2019. [Epub ahead of print].