The document provides guidelines for determining the best glasses prescription for patients with keratoconus based on their topography patterns, including starting with the least minus sphere and small cylinder to maximize vision while minimizing distortion, using binocular trials to account for changes from torsion and accommodation, and considering anisometropia and ways to improve binocularity. It discusses different approaches for central cone, oval cone, snowman, and peripheral cone patterns identified on topography.