ALB and keratoconus: In the literature, the neutrophil-to-lymphocyte ratio (NLR) has been shown to increase in various ocular conditions, such as keratoconus, glaucoma, pterygium, and idiopathic epiretinal membrane, due to its link with the cellular immune response.[4] The modified systemic inflammation score (mSIS), which incorporates serum albumin levels and the lymphocyte-to-monocyte ratio (LMR), is a systemic inflammation scoring index commonly used to evaluate prognosis in various cancer types.[5–7] According to this scoring system, a score of 0 is assigned when albumin levels are ≥4.0 g/dL and LMR is ≥3.4.