Keratoconus is a progressive, bilateral, non-inflammatory eye disorder in which the cornea of the eye alters in shape and thickness, eventually forming a cone-like shape. The cornea affected by the disease changes its curve and tends to be thinner than the normal cornea, causing progressive impairment of visual acuity, usually in terms of progressive nearsightedness and/or irregular astigmatism. The prevalence of keratoconus is usually estimated between 50 and 230 per 100 000. The process typically starts around puberty and continues over a period of 10-20 years until it gradually stops. The etiopathogenesis of keratoconus is yet to be discovered. However, the weakening of the stroma is probably the most important factor in keratoconus development. Management of keratoconus varies significantly depending on the stage of the disease. Control of progression and visual acuity correction are its main goals. Over the past 10 years, great effort has been put into research of corneal cross-linking, which has already shown stable long-term results in the control of keratoconus progression. In terms of correcting visual acuity, spectacle correction is limited and used in early stages only. Traditional RGP contacts, as well as special, keratoconic designs like Rose K, piggybacks or hybrid contact lenses are the mainstay method in correcting moderate to advanced keratoconus. In cases of contact lens intolerance, photorefractive keratectomy and intracorneal ring segment insertion are considered. Except from visual acuity correction, these surgical methods provide better postoperative contact lens fitting. In cases of very advanced keratoconus, corneal transplantation is often the only treatment option. Even though penetrating keratoplasty has traditionally been the surgery of choice, lamellar keratoplasty is recently becoming more popular, especially for patients with mild to moderate disease.