Corneal biological parameters have a certain influence on IOP measurements, such as central corneal thickness (CCT) and corneal curvature. Since the first optical measurement of central corneal thickness by Blix et al. in 1880, the measurement of corneal thickness has become more and more important due to the needs of clinical work and scientific research, especially the development of refractive surgery. 1980, Kremer et al. first used ultrasonic corneal thickness gauge to measure corneal thickness in multiple directions, which was more accurate than the previous optical corneal thickness gauge. The results were more accurate than those obtained with the previous optical corneal thickness gauge. Although the Goldmann flattening tonometer is the gold standard for IOP measurement, Goldmann and Schmidt set the parameters of the flattening tonometer with the assumption that the variability of the central corneal thickness value was small and was assumed to be 520 um. With the development of optical technology and later the widespread use of ultrasound detectors, the central corneal thickness can be measured more accurately and the distribution of the measured values is much wider than that recognized by Goldmann. The range of measurements was much larger than Goldmann had recognized. As early as the 1970s, Johnson et al. noted the influence of central corneal thickness on Goldmann’s flattening IOP measurements in multiple directions. Ehlers et al. were the first to suggest that the systematic error in GAT measurement IOP accuracy was linearly correlated with central corneal thickness, and their study found that GAT measurements were most accurate at a corneal thickness of 520 um; every 70 um deviation in central corneal thickness would increase or decrease the GAT measurement IOP value by 5 mmHg, i.e., corrected IOP = corrected IOP before + (520 – central corneal thickness) / Doughty et al. concluded that the distribution of central corneal thickness values in the normal population was wide and generally normal, with a mean value of 544 ± 34 um (using an ultrasonic corneal thickness gauge). Doughty et al. suggested that the IOP should be corrected for central corneal thickness values: for every 50 um deviation from normal values, the IOP should be reduced by Previous studies have also shown that for every 10 um increase in central corneal thickness, the change in IOP ranges from 0.18 to 0.63 mmHg. Herndon et al. found that the central corneal thickness in patients with hypertension was 606 ± 41 um, much greater than that of primary open angle glaucoma (POAG) (554 ± 22 um) and normal human eyes (561 ± 26 um) (P < 0.001), while the difference between the latter two was not statistically significant (P = 0.40).Herman et al. in the Mayo Hypertension In a clinical study of Mayo hypertension, 55 patients with hypertension and 55 age-matched normal subjects were observed, and the central corneal thickness of the former was much higher than that of the latter (P < 0.001). Medeiros et al. reported that the central corneal thickness was significantly higher in patients with hypertension compared to the normal population, POAG, and pseudoexfoliative glaucoma, while there was no significant difference between the first three. Therefore, IOP measurements in patients with hypertension with large central corneal thickness will be higher than their actual IOP values. Patients with NTG have a thinner central corneal thickness (510 um). Copt et al. showed that the central corneal thickness of NTG is thinner than POAG and normal controls, so the IOP measurements of NTG patients are lower than the actual IOP values. After removing the effect of corneal thickness according to the Ehlers IOP correction formula, 56% of patients with hypertensive eye can be classified as normal and 31% of normal pressure glaucoma can be be classified as primary open-angle glaucoma. Dohadwala et al. proposed that when patients have abnormal IOP measurements, central corneal thickness should be measured to truly describe IOP values for proper diagnosis and treatment; Damji et al. suggested that central corneal thickness measurement should be performed in patients with hypertensive IOP with normal corneal morphology and in patients with normal IOP who can betray the ratio; Foster et al. suggested that the difference in central corneal thickness is the cause of the normal population If IOP is considered the most important risk factor for glaucoma progression, central corneal thickness measurement should be considered to evaluate IOP realistically. In the report of the ocular hypertension treatment study (OHTS) group, a central corneal thickness of 556 um was used as a threshold for differentiating corneal thickness, but its normal variability is large and ultrasonic corneal thickness measurement is recommended. Central corneal thickness is positively correlated with IOP to some extent, is a strong negative correlate in determining the prognosis of hypertension, and is one of the risk factors for the development of hypertension to glaucoma. Patients with a thick cornea and moderately high IOP may find that their actual IOP is in the normal range and their chances of developing glaucoma are very low when they are corrected for IOP by the central corneal thickness value. Patients with thin corneas and high IOP values have a higher chance of developing glaucoma. Corneal curvature has a smaller effect on GAT and NCT measurements compared to central corneal thickness. The analysis considered that steeper corneal curvature increases corneal stiffness, which results in higher GAT and NCT measurements. At the same time, the tear ring around the corneal pressure flattening area is relatively thicker after the GAT pressure head touches the cornea, resulting in an increase in the attraction of the cornea to the pressure head, which leads to higher GAT measurement values. The influence of corneal curvature on the measurement results of the pressure flattening tonometer is still inconclusive. Zhang Yang et al. reported that for every 1 mm increase in corneal curvature, GAT measurements decreased by 2.648 mm Hg and NCT measurements decreased by 3.190 mm Hg. Gunvant et al. reported that for every 1 mm increase in corneal curvature, GAT measurements decreased by 1.14 mm Hg and NCT measurements decreased by 2.6 mm Hg. Mark reported that the flatter the corneal curvature, the lower the IOP measurements. Mark reported that the flatter the corneal curvature, the lower the IOP measurement. Harada et al. also suggested a negative correlation between GAT measurements and corneal curvature. However, this has been reported differently, and Eysteinsson et al. found no correlation between corneal curvature and IOP values measured by NCT in a study of 925 eyes. Recently, many studies have focused on other corneal biophysical properties, such as corneal hysteresis (CH) and corneal resistance factor (CRF), etc. Morita et al. used an ocular response analyzer (ORA) to measure IOP in NTG patients. The analysis found that the difference between CCT and normal controls was not significant in NTG patients, but rather the lower CRF and CH values resulted in lower GAT IOP measurements in NTG patients, and therefore the corneal parameters (CCT) compensated IOP values were significantly higher in NTG patients than in normal controls. Further analysis concluded that CH was significantly correlated with GAT IOP measurements and CRF, but not with CCT, thus suggesting that CH and CRF are risk factors for glaucoma independent of IOP. mean cup depth (MCD) and cup-to-disc ratio (CDR) were significantly correlated, whereas CCT was only correlated with MCD, thus suggesting that patients with thin corneas and low CH in POAG had larger cups and deeper cups. Altan et al. found that in patients with true microphthalmia, CH, CRF and GAT IOP values were significantly higher, whereas corneal parameters (CCT) compensated IOP values were not significantly different from normal controls, suggesting that CH and CRF are more worthy of reference when judging IOP measurements. The influence of corneal biophysical properties on IOP measurements must be taken into account in the clinical consultation and follow-up of patients with hypertension, which will allow patients to avoid potentially unnecessary early IOP-lowering treatment and will also eliminate the psychological stress caused by misdiagnosis of glaucoma.