Keratoconus is a relatively rare, slowly progressive, non-inflammatory thinning and distortion of the cornea. Clinically, we see the development of irregular astigmatism, increasing corneal curvature and corneal scarring. Thus use of rigid contact lenses to increase visual performance by masking the advancing corneal distortion is the traditional prescriptive therapy. We report an unusual case of a 42 year old, white female who presented to our Low Vision Service from an agency for the partially sighted. She had incoming complaints of photophobia and sensitivity to glare. She was requesting low vision aids to assist her reading skills. She was currently using a cane that was given to her during orientation and mobility training. Case history revealed that keratoconus was diagnosed at the age of 7. The patient was declared legally blind on the basis of acuities 6 years prior to our initial visit. The patient had no visual correction and presented with entering acuities of 1/700 OU. The patient was fit with rigid contact lenses 3 years previously but discontinued lens wear due to unacceptable vision and comfort. The patient was re-fit in rigid contact lenses at our clinic, which provided acceptable comfort and measured visual acuity of 20/40+2 OD and 20/50+2 OS. This case illustrates the value of appropriate referrals and management.