Abstract: Keratoconus is a kind of corneal disease which mostly affect adolescent and could cause blindness, characterized with significant thinning as well as cone-like protruding of cornea. Advanced stage of the disease could be diagnosed by clinical symptoms and examinations of ocular anterior segment easily. However, it is difficult to detect when keratoconus is of early stage, including suspected keratoconus, subclinical keratoconus and forme fruste keratoconus, due to its subtle corneal changes and mild vision loss. Corneal topography is now the most common method being used to diagnose the disease. As another approach to obtain corneal morphology, optical coherence tomography gradually gains more attentions. Ocular reactive analyzer and Corvis ST device could find structure alternations earlier than morphologies by measuring ocular biomechanical parameters. A number of parameters could be obtained by various devices, artificial intelligent technologies has already been used to investigate the regulations of those parameters in diagnosing early keratoconus. Additionally, susceptible genes or biomarkers been investigated would be helpful to differentiate high risk population, reminding them to have ocular examinations regularly in order to find abnormalities as early as possible. (Int Rev Ophthalmol, 2022, 46: 60-65)

Key words: keratoconus/diagnosis, Corvis biomechanical index, tomographic biomechanical index, maximum epithelial ectasia index, genetic diagnosis