Corneal sensitivity has recently received much attention given the crucial role the corneal nerves play in maintaining normal corneal structure and function. An increased understanding of the corneal sensitivity and dry eye disease in keratoconus, including alterations of the conjunctival cells, may help explain the pathogenesis of this disorder. There is histological evidence of the involvement of corneal nerves in the pathology of keratoconus and it has been suggested that this plays a role in the pathophysiological features and progression of the disease. In this review, the impaired corneal sensitivity found on keratoconus and corneal sensitivity changes after cross-linking performed in patients with keratoconus are reported.