Corneal topography (normalized scale) shows asymmetrical vertical bowtie astigmatism with some inferior steepening. Keratoconus possibility index (KISA) is within normal (<60%> no Keratoconus), it is 4 for the right and 5 for the left.
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Does this patient have Keratoconus? Would LASIK procedure be an option for him? Does he need any other management? 
5 comments:
A case of bilateral irregular astigmatism.
LASIK could be a line of ttt.
This case could be considered a Keratoconus form fruste, which is characterized by asymmetric bow-tie with increased steepening inferiorly and it should be detected by normalized scale
In my opinion, LASIK surgery would be too risky. First, because of the considerable inferior steepness and second, because his pachymetry values are below normal in one eye (less than 500 microns) and the other is eye is borderline.
you need an expert professor to give a final comment on each case, according to subspeciality. That will give a great value to the comments.I can see in the comments on some cases, like case number 10, that there is an abuse of your blog, how can you protect your valuable blog?.. thanks
I think Orbscan should be done on this patient and then proceed.
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