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The aim of this study was to evaluate the corneal higher-order aberrations (HOAs) in first-degree relatives of patients with keratoconus (KCN) and compare with the normal population. In this prospective comparative study, 210 eyes from 105 family members of 28 patients with KCN and 210 normal eyes of 105 controls were enrolled. In each eye, corneal topography, tomography, and aberrometry were performed and compared between the 2 groups. This study included 61 female (58.1%) and 44 male participants (41.9%) and 105 age-matched and sex-m