+4 more
Please interpret this report
Reading File
Finding Sources
Finding Sources
What This Is
These four images are printouts from a Scheimpflug corneal tomographer (CSO Sirius/Sirius+ system) for patient Kumar Gaurav (record shows age 12), scanned on 21-08-2026, one set for each eye - OD (right eye) and OS (left eye). This type of scan is most commonly ordered to screen for keratoconus (a progressive thinning/bulging disorder of the cornea) - either because of family history, unexplained blurred vision, before refractive surgery, or before fitting contact lenses/ortho-K. This is exactly the kind of Scheimpflug-based corneal mapping described for ectasia screening in - Kanski's Clinical Ophthalmology, 10th ed.
Each eye's printout has 4 maps plus a numeric summary:
- Tangential anterior curvature - shape/steepness of the front corneal surface
- Corneal thickness (pachymetry) - thickness map across the cornea
- Anterior elevation - how the front surface deviates from a smooth reference sphere
- Posterior elevation - same, for the back surface (the most sensitive map for early ectasia)
Right Eye (OD)
| Parameter | Value | Comment |
|---|---|---|
| Thinnest point (Thk MIN) | 541 µm | Normal (normal range ~500-600 µm) |
| Anterior K-max | 43.56 D | Normal (concerning threshold is generally >47 D) |
| SimK (flat/steep/avg) | 42.32 / 42.84 / 42.58 D | Normal corneal power |
| Corneal astigmatism | -0.52 D @ 5° | Mild, unremarkable |
| TSI (Tomographic Screening Index) | 6.28 µm | - |
| TI_max | 1.46 (flagged red) | Slightly elevated - borderline single index |
| Software classification | Normal | - |
| ACD / angle / WTW | 3.67 mm / 48.8° / 11.89 mm | Normal anterior chamber |
Left Eye (OS)
| Parameter | Value | Comment |
|---|---|---|
| Thinnest point (Thk MIN) | 543 µm | Normal |
| Anterior K-max | 43.06 D | Normal |
| SimK (flat/steep/avg) | 42.15 / 42.73 / 42.44 D | Normal |
| Corneal astigmatism | -0.58 D @ 5° | Mild, unremarkable |
| TSI | 4.84 µm | Normal |
| TI_max | -0.60 | Normal, not flagged |
| Software classification | Normal | - |
| ACD / angle / WTW | 3.59 mm / 49.5° / 11.70 mm | Normal |
Overall Interpretation
- Both eyes are classified "Normal" by the device's built-in keratoconus-screening algorithm.
- Corneal thickness is symmetric and within normal limits in both eyes (541 vs 543 µm), with no focal thinning pattern typical of ectasia.
- K-max values (43.06-43.56 D) are well below the ~47-48 D threshold that raises concern for keratoconus, and the anterior curvature maps show a fairly regular, symmetric pattern rather than the classic asymmetric "bowtie" or inferior steepening seen in early keratoconus.
- Mild, low, and symmetric astigmatism (~0.5-0.6 D) in both eyes - not clinically significant on its own.
- The one point worth flagging: the right eye's TI_max = 1.46 is highlighted in red, meaning this single index crossed the software's internal reference cutoff, even though the eye's overall composite classification still reads "Normal." This kind of isolated single-index flag (without matching abnormal K-max, thickness, or curvature pattern) is usually a soft/borderline signal rather than a diagnosis of keratoconus, but in a young patient (12 years old per the record) it is reasonable to treat it as a "watch" finding.
Practical Takeaway
- No frank keratoconus or ectasia is shown on either eye based on the standard indices (K-max, minimum thickness, elevation maps, screening classification).
- Given the patient's young age - the peak age range for keratoconus onset/progression is the teenage years - and the isolated red-flagged TI_max in the right eye, serial (repeat) topography in 6-12 months would be the standard recommendation to confirm stability, rather than a single normal reading being fully reassuring.
- This interpretation should be correlated by the treating ophthalmologist with the patient's refraction, family history, and clinical exam (e.g., checking for Vogt's striae, Munson's sign, or scissoring retinoscopy reflex) before final counseling.
A quick check of recent literature (systematic reviews/meta-analyses on pediatric keratoconus screening, last 2 years) didn't surface anything that would change this device-based interpretation - the Belin/Ambrósio-type tomographic indices used here (K-max, TSI, TI_max, pachymetry) remain the current standard screening approach.
This is a shared conversation. Sign in to Orris to start your own chat.