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Aims/Purpose: To determine the corneal topographic indices of Scheimpflug camera in type 2 diabetic and non‐diabetic in elderly population of Tehran, Iran. Methods: A total of 1105 subjects were selected using random cluster sampling from Tehran, Iran and categorized into two groups including diabetics and non‐diabetics. The diabetic group had HbA1c levels ≥6.4% with no other systemic problems. The non‐diabetic participants had normal eye findings and no systemic diseases. The keratometry values, Q‐value, index of surface variance (ISV), index of vertical asymmetry (IVA), central keratoconus index (CKI), keratoconus index (KI), index of height asymmetry (IHA), index of height decentration (IHD), anterior average radius of curvature (ARC), posterior average radius of curvature (PRC), and pachymetric progression index (PPI) values were measured using the Pentacam AXL. Results: A total participants included 429 diabetic (38.46% male) and 676 non‐diabetic (38.76% male). Only PPIavg and PPImax were higher in the diabetics versus non‐diabetics (p = 0.019 and p = 0.010, respectively). The HbA1c level was 5.47 ± 0.34, 6.70 ± 0.17, and 8.72 ± 1.16 in the first, second, and third group, respectively. There was a significant difference in PPImax between the three groups (p = 0.036). There were significant differences only in IVA, CKI, PPIAvg, and PPImax between different stages of DR (p = 0.045, p = 0.005, p = 0.002, and p = 0.004, respectively). The diabetic subjects were divided into two groups based on the presence of DR. There was a significant difference in ISV, IVA, PPIavg, and PPImax between diabetic subjects with and without DR (p = 0.016, p = 0.022, p < 0.001, and p < 0.001, respectively). Conclusions: The results of this study showed that DM and DR change several topographic indices and the HbA1c level may affect PPImax. Therefore, special attention should be paid to these patients for different treatment strategies. [ABSTRACT FROM AUTHOR]