KERATOCONUS Non -Inflammatory central corneal thinning Young male with constantly changing power of glasses with myopia & high cylinder SIGNS IN KERATOCONUS Munson sign. Enlarged corneal nerves-lower lid indentation on downgaze. Oil droplet reflex. Rizutti's sign- Acute Hydrops - aqueous accumulated in stroma Fleischer ring-Paial or complete iron deposition ring in deep epithelium encircling the base of the cone. Characteristic in eyes with keratoconus. Scissor reflex on retinoscopy (Earliest Clinical Sign) Keratometry Steep cornea. Bow tie pattern Paracentral thinning of cornea Investigation of Choice Pentacam