Tomographic findings of Keratoconus

Quad map and Enhanced Ectasia map

A 21 year old man with history of eye rubbing presented with diminished visual acuity in both eyes.
His BCVA in both eyes:
OD: -6 DS, -4 x 180
OS: -6 DS, -4.5 x 180
Improving to 6/9 in both eyes
On retinoscopy, scissoring reflex was observed
Pentacam was done which showed the above findings which is suggestive of advanced keratoconus in both eyes

Image from Rajan Eye Care Hospital

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Punctate Staining Patterns of Ocular Surface