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As a degenerative disorder of the eye, keratoconus can cause substantial distortion of vision, with multiple images, streaking, and sensitivity to light all reported by patients. Keratoconus: Recent Advances in Diagnosis and Treatment updates ophthalmologists about the innovations that have occurred within the last decade, discussing the diagnostic imaging techniques that have been developed for keratoconus diagnosis, understanding of how examination techniques are related to the evolution of keratoconus, and how to indicate the different therapeutic tools that have been created for keratoconus over the last several years. Additionally, fundamentals for new diagnostic elements, based on the mathematical, physical and biomechanical data are analyzed in depth for a better understanding of the essential diagnostic steps for the clinician to guide patients towards the most adequate therapeutic tool in the case. Modern keratoplasty techniques, assisted by femtosecond lasers or other devices, are also covered and these techniques, along with the emerging conservative treatments, have added to more precise control of the evolution of the disease.