Keratoconus is a non – inflammatory ectatic condition of cornea that usually manifest during puberty. There is a progressive thinning of cornea leading to conical protrusion which induces irregular astigmatism resulting in visual impairment. Acute corneal hydrops is the development of marked corneal edema due to tear in the descemet’s membrane followed by leakage of aqueous into the stroma. ACH is a well-known complication occurring in approximately 3% of patients in keratoconus. Hormonal changes during pregnancy may have a negative impact on corneal biomechanics therefore indicating the pregnancy may be previously recognised risk factor for keratoconus. A high number of reports from eye clinics show pregnancy induced exacerbation of keratoconus. We present a case of 27 yrs. female with bilateral keratoconus. She presented to us with acute corneal hydrops in left eye and early keratoconus in the right eye at 34 th week of gestation.