Case 9

A 45 years old male is presenting to do refractive surgery to get rid of his glasses. Ocular examination is normal. His glasses are Rt. sphere -5.25 cylinder -2.50X155, Lt. only cylinder -3.50X145. His BCVA is 0.5 bilateral. Corneal pachymetry and topography were done and his central corneal thickness in the right 495 microns and left 504 microns.

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?