Keratoconus (KCN) is a progressive corneal disorder marked by thinning and steepening of the cornea, often leading to visual distortion and decreased acuity. It typically manifests between the second and fourth decades of life. Diagnostic advancements in topographic and tomographic imaging have improved early detection, which is critical for effective intervention. Early intervention in progressive KCN includes corneal collagen cross-linking (CXL). While the epithelium-off Dresden protocol for CXL is the gold standard, various modified techniques are being developed to improve safety, comfort, and outcomes. Additional treatments such as intracorneal ring segments (ICRS), photorefractive keratectomy (PRK), and emerging strategies like Bowman’s layer transplantation serve to enhance vision or delay the need for corneal transplantation.