- Purpose To determine videokeratographic topography of eyes with vernal keratoconjunctivitis (VKC) and to assess whether the severity of the VKC is related to the presence of changes compatible with keratoconus. Participants Seventy-six persons aged 6 to 21 years: 40 patients with VKC and 36 healthy controls. Design A comparative, observational case series. Methods We examined 76 persons, of whom 40 were patients with VKC and 36 were control subjects, and compared the outcomes of videokeratography (VKG) patterns (EyeSys Laboratories, Houston, TX), numerical corneal indices, and spherical equivalent refraction. Main outcome measures Corneal topographic patterns, corneal numeric indices, and corneal mirror imagery. Results We found many more abnormal patterns on VKG among the VKC patients than expected when compared with ‘normal' eyes ( P = 0.02 for the right eye and P = 0.001 for the left eye). Videokeratography allowed us to define a subgroup of patients with infraclinical keratoconus. A trend of superior corneal steepening (‘superior keratoconus') was also found. Conclusions Vernal keratoconjunctivitis patients have more abnormal corneal topographic patterns than non VKC controls. Videokeratography may help decide how to follow-up and treat a presumed self-limiting disease.