Accompanying with the recent hunt for the genetics causes of KC, such as TFE3, TFEB, or MITF gene fusions, the overall genetic alterations of PI3K/AKT pathway comprising PIK3CA (2.8%), PIK3R1 (0.4%), PIK3R2 (0.3%), AKT1 (0.5%), AKT2 (0.6%) and PTEN (4%, Table 1) are captured in KC. Here, PIK3R1 is linked to keratoconus.