Corneal biomechanics is a modern field in ophthalmology, which studies the corneal capability to deform reversibly. The Ocular Response Analyzer is a non-contact techniqueTechnique to measure the corneal biomechanical properties in vivo. Corneal biomechanical assessment plays an important role in the screening, diagnosisDiagnosis, prognosis and clinical follow-up for ectatic corneal diseases such as keratoconusKeratoconus or pellucid marginal degeneration. Furthermore, it could be used to predict and determine the impact of corneal refractive surgery and laser refractive procedures such as LASIKLASIK, PRK and SMILESMILE on the biomechanical properties of the corneaCornea. However, to date there is no gold standard measurement techniqueTechnique of corneal biomechanical characteristics. We explain the measurement techniqueTechnique and the data analysis of the Ocular Response Analyzer and discuss its clinical application for the diagnosisDiagnosis of keratoconus, keratoconusKeratoconus suspect and pellucid marginal degeneration. Furthermore, we evaluate measurable changes of corneal biomechanics after corneal crosslinkingCorneal crosslinking and after intrastromal corneal ring segment implantation. We acknowledge the growing important role of the Ocular Response Analyzer in the management of corneal ectasias and in the pre- and postoperative assessment for refractive procedures and we encourage an implementation of corneal biomechanical testing into the clinical setting. Nevertheless, further research and validation are indispensable for establishing the Ocular Response Analyzer as a standard screening techniqueTechnique to evaluate biomechanical strength and stability in the context of corneal refractive surgery.