Keratoconus is usually classified as an asymmetric, progressive ectasia of the cornea. It is non-inflammatory and is characterised by thinning, steepening and scarring of the central cornea (Krachmer et al. 1984, Rabinowitz 1998). The disease progresses from initial symptoms of mild visual disturbance and frequent changes to the spectacle prescription to severe visual impairment in the latter stages of the disease from corneal scarring and hydrops. The management of this condition is predominantly optometric in the early stages through the provision of spectacles or contact lenses. As the disease progresses specialist contact lens fitting may be required and when these options have been exhausted, surgical intervention may be indicated (Lass et al. 1990). 

The aim of this review is to familiarise the optometrist in primary optometric practice with the relevant literature, signs, symptoms and non-surgical management options for keratoconus.