Keratographic analysis of a family with keratoconus in identical twins

We screened family members of monozygotic twins with keratoconus to search for a corneal thinning disorder using clinical, videokeratographic, and pachymetric analyses. The parents had bilateral astigmatism of a symmetric bow-tie pattern with normal videokeratographic and pachymetric indices. The 8-year-old sister had slightly asymmetric astigmatism in both eyes with normal pachymetry values. No family member was suspected of a corneal thinning disorder. We discuss the mode of inheritance of keratoconus in this family.