This is a single author publication addressing the subject of ectatic corneal disorders and keratoconus (when, why, and why not) with a step by step systematic approach to management using modern sophisticated diagnostic and screening tools. It is comprised of four chapters.

The first chapter discusses three major important classifications of keratoconus, based on morphological, tomographic (according to elevation maps, to thickness maps or to curvature maps) and suggested by Krumeich, with tables and figures. In addition, the author has shared his own experiences by mentioning a new classification of the tomographic pattern of keratoconus with simple and topographic illustrations. Three entities related to keratoconus with clinical and tomographic findings on the pellucid marginal degeneration, forme fruste and pellucid – like keratoconus – are also described in detail.

The second chapter includes different treatment modalities for the management of ectatic corneal disorders including non-interventional (spectacle correction and contact lenses), interventional conductive keratoplasty (CK), penetrating keratoplasty and deep anterior lamellar keratoplasty (DALK), intracorneal rings (ICRs), corneal collagen cross- linking with indications and contraindications, phakic intraocular lenses (PIOLs) and combined treatment modalities with high-quality illustrations, tables and flow charts.

The third chapter consists of a checklist and three-step approach to nine cases. Step 1 is the analysing step for patient clinical data and curvature and thickness maps, followed by management suggestion steps and, at the end, discussion steps with tables.

In the last part of this book, self-assessment with suggestions is presented for the reader to develop their own skills and knowledge. This is a unique feature of this book with scenarios giving different parameters, main maps and anterior sagittal maps, then suggestions are provided. This book covers all the important aspects of the management of corneal ectasia and keratoconus. There is a lack of references for each chapter though a bibliography is given after the first two chapters, plus an index at the end followed by figures and tables.

Overall the book is good and covers an important subject successfully in a short volume. The price is fair given the detail of text on this topic. This book represents good value for optometrists in corneal clinics, postgraduate students if they have a sufficient basic knowledge of corneal topography and experienced ophthalmologists.

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Amtul Mussawar Sami

Lahore, Pakistan

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