Investigative technology in the field of corneal refractive surgery has seen a rapid evolution in the last two decades. The shift from corneal topography system to corneal tomography analysis has not only improved the accuracy of corneal contour analysis but has also given an opportunity to explore various additional findings that are now considered extremely valuable in the diagnosis of forme-fruste keratoconus. This is of paramount importance in today's world considering the high flow of patients for refractive surgery and the need for precise screening for corneal ectasia in these cases prior to surgery. Pentacam (Oculus Wetzlar, Germany), based on Schiempflug imaging, is the most commonly used corneal tomography system. It creates a 3-D imaging of the anterior segment and provides details of the anterior and posterior corneal contour, pachymetery, anterior chamber depth and pupil diameter. Recent advancement in the Pentacam software enables IOL power calculation as well phakic IOL simulation.