Abstract Keratoconus is a degenerative structural disease of the cornea. Progression leads to poor acuity that is not easily correctable by standard means. New treatments, such as collagen cross-linking, lead to better long-term outcomes if performed early in the disease course. Currently, children in the USA are screened for acuity in school, but not for keratoconus. Due to the severity of the disease in children, we recommend topographic screening in elementary schools as a way to provide early detection and treatment. Funding Research to Prevent Blindness provided funding for the Rapid Service Fees.