• Confusion when evaluating effective keratoconus fix with the Athens protocol CXL Description: This interesting case illustrates a 22-year-old young gentleman treated with the Athens protocol CXL back in 2014 in his right eye for progressive keratoconus our assessment was that the treatment was extremely successful as in our last follow up the patient in 2018, 4 years postop was enjoying in aided vision close to 20/25, excellent normalization and stability in his left eye! The same data were recently reviewed by a colleague in Northern Greece who for some reason considered the right eye to be a “disaster” and the left demanding “immediate” CXL!!! It is not uncommon in my opinion if one does not carefully evaluate all data especially preoperative data to become confused when assessing keratoconus. I hope this case in this discussion helps us understand better the intricate details in diagnosing and treating keratoconus Subspecialty: Cornea / External Disease Level: Advanced Uploaded By: A. Kanellopoulos