This document discusses dry eye syndrome in patients with keratoconus. It notes that keratoconus patients are more susceptible to developing dry eye due to changes on the ocular surface from high keratometric values and other factors like scratching and contact lens use. The document outlines tests for diagnosing dry eye like break up time tests and staining of the cornea and conjunctiva. It recommends a multidisciplinary treatment approach including managing risk factors, preventative care, anti-inflammatory treatment if needed, and considers intracorneal ring segments which may improve keratometry and reduce dry eye symptoms. The conclusion reiterates that keratoconus patients are more prone to dry eye and emphasizes the importance of a healthy