This patient was diagnosed with Posterior Keratoconus, a rare, typically congenital corneal disorder characterized by stromal thinning resulting in an internal protruberence of the posterior corneal surface. Vision loss is typically mild to moderate with treatment dependent upon severity and presence of secondary conditions. Stromal scarring generally present in thinned zones, with an epithelial iron ring usually present around anterior protrusion. Treatment follows typical keratoconus management; glasses, contact lenses, and keratoplasty, if needed. Return to case history