I suppose, when all rust is removed the keel won't be smooth as a baby's bottom. Should I worry and address this or is it just optics?
I wouldn't bet on it, some cast iron keels can become 'slabby' over the years... where corrosion tracks under the surface causing thin layers to detach in patches..
This is obviously likely to occur during grit blasting and results in an uneven surface...
It's also worth noting that quite a lot of moisture can get trapped beneath these layers and the keel should be allowed to dry after grit blasting and before any treatment applied....
Although aesthetically poor, None of this affects the integrity or functionality of the keel and as suggested by others blasting is the way to go as apposed to grinding....