The purpose: This paper aimed to analyze the keratometric, topometric and pachymetric features of keratoconic suspect and clinical keratoconic eyes from normal thin ones using a Scheimpflug imaging camera. Patient and methods: The study was retrospective and cross-sectional and examined the eyes of candidates seeking refractive surgery at Sohag ophthalmologic Centre. The study included 26 normal subjects with 31 eyes with thin corneas (<480 µm), 14 subjects with 18 eyes diagnosed as keratoconus suspects, and 18 patients with 39 eyes keratoconus (stage 1 and 2). The approval of the ethical committee of Sohag University Hospital was acquired. Results: showed that a possible indicator to distinguish between thin corneas and keratoconus grade 1 & 2 was provided by information on the corneal height, particularly in the case of applying the enhanced ectasia presentation. Parameters from BAD display (e.g., anterior, posterior elevation differences and final D), topographic parameters (such as Q value, KI, K2, Kmean, Kmax and cylinder), topometric parameters (such as KI, IHD, IVA, IHA, CKI, and ISV values), and pachymetric parameters (such as average PPI and ARTmax) helped discriminate the keratoconus cases with the highest prediction accuracy. Conclusions: This study shows that these eyes may be discriminated efficiently using different tomographic (BAD, pachymetry, and elevation) parameters and topometric indices from Pentacam Scheimpflug tomography. It addresses non-keratoconic thin corneas and keratoconus subclinical or mildly evolved. CT at apex, thinnest CT, IVA, IHD and PE differences tended to be the most appropriate for distinguishing subclinical keratoconic eyes and normal thin corneas.