This video shows what the Rizzuti’s light reflex looks like in eyes with keratoconus. You perform this test by shining a penlight into the eye at an oblique angle. The cone shape of the cornea causes the resulting iris light reflection to a point. This is hard to explain, so you should check out the video.
Other exam findings of keratoconus include Munson’s sign (notching of the lower eyelid when looking down) and a Fleischer ring (a corneal iron line around the base of the cone).
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rizzutisign.wmv (2.7 meg, Windows video file)