Tomographic Parameters for the detection of keratoconus: Suggestions for screening and treatment parameters

Tomographic corneal evaluation has added significantly moreinformation in the evaluation of the ectatic cornea. Additional informationfrom the posterior cornea and a full corneal thickness map in addition toanterior corneal analysis has increased the ability to identify early andsubtle corneal changes. Although these newer examination modalities haveincreased our sensitivity in refractive screening, problems still persist whenattempting to assure treatment trials (such as collagen cross-linking) forearly disease are performed to an appropriate patient population. This articlewill review past and present diagnostic capabilities with a particularemphasis on refractive screening and early treatment studies and stressthe limitations of our current diagnostic ability when it comes to diagnosingearly ectatic change.