Sign in keratoconus:
On direct ophthalmoscopy-
• Oil droplet reflex
On slit lamp examination-
• Fleischer’s ring (Iron deposition in the corneal epithelium)
• Vogt striae
On retinoscopy-
• Scissor reflex
Munson’s sign-
• When the patient looks downward, the inferior lid protrusion is a classic clinical sign of advanced keratoconus. It occurs due to the cone-shaped protrusion of the cornea.
Figure- Munson’s sign in keratoconus
Keratoconus grade |
Curvature of anterior corneal wall |
Mild |
< 58D |
Moderate |
48 - 54D |
Severe |
> 54D |