Keratoconus is the most common of the primary ectasia and is characterized by bulging and thinning of the central cornea. Having a multifactorial nature (intrinsic biomechanical susceptibility and environmental factors), its evolution is markedly dependent on weakening procedures of the corneal stroma, such as eye rubbing or laser vision correction surgeries, among others. The understanding of the disease by the patients who suffer from it is mandatory. This chapter provides clinical examples that highlight the current aspects of diagnostics for individualized decisions considering the treatment options available to manage this condition.