Keratoconus(KC)is a disease characterized by limited corneal cone-like protrusions accompanied by thinning of the corneal stroma in the area of protrusion, which commonly occurs before and after puberty, manifests itself bilaterally, and is a potentially blinding ophthalmic disease. It is a potentially blinding eye disease. Studies have shown that its pathogenesis is related to environmental factors, inflammatory response, immune function, and mechanical stimulation, but the mechanism of the occurrence and progression of KC has not yet been conclusively determined. A variety of genes, represented by corneal remodeling-related genes, have been found to have some influence on the development of cone cornea. More studies are still digging into the genetic targets associated with the development of cone cornea. This article reviews the targets and influence of genes in the pathogenesis of cone cornea, to explore the application value of genes in the early diagnosis and intervention of cone cornea, and to provide new ideas for future research on the pathogenesis of cone cornea.