40-years male presented to Cork university hospital, Ireland complaining initially with bilateral blurry and distorted vision since few months ago. He had myopia -5 dioptre wearing glasses for many years and he decided to take his glasses off and corrected his myopia by LASIK (Laser assisted in-situ Keratomileusis) for 5 years ago in Syria. No medical or family history of eye disease. On biomicroscopy examination reveals normal lid, white conjunctiva, normal lacrimal apparatus, bilateral corneal flaps are intact, no flap complications or corneal infection, bilateral irregular contour of the cornea, thinning the cornea inferiorly, anterior chamber was deep and quiet, regular iris configuration, bilateral clear red reflex and bilateral clear natural lenses. Dilated fundoscopic examination showed a myopic sign such as bilateral peripheral choroi-retinal degeneration, peripapillary atrophy, and typical type of lattice degenerations at supero-temporal quadrants of both eyes. He had healthy optic nerve, cup disc ratio 0.3 bilaterally, retina flat and healthy dry macula. He had a Scissors reflex on retinoscopy, Munson sign (increased angulation of lower lid margin at down gaze due to protrusion of the cornea), Oil droplet reflex of Charleaux with direct ophthalmoscope, he had irregular astigmatism with inability to correct the patient to 20/20 with manifest refraction.

Keywords : Lasik, Corneal ectasia, corneal topography, optical coherence tomography, keratoplasty.