We studied two sets of identical twins with keratoconus. The first 21-
year-old pair had bilateral fully developed keratoconus and the second
35-year-old pair presented with early bilateral keratoconus detected
by videokeratography. To our knowledge, these are the seventh and eigh
th sets of identical twins with keratoconus reported in the literature
. They support the evidence of heredity as a factor in the etiology of
keratoconus. Videokeratography proved to be a valuable adjunct for th
e detection of early keratoconus in a cornea with normal slit-lamp mic
roscopy and photokeratoscopy results. Radial keratotomy in one eye pro
duced an unstable refraction.