The association between innate and adaptive immune systems with ocular surface inflammation and dry eye has been approved. Similarly, the most notable changes observed in tear fluid of KC patients are the significantly higher levels of IL-1β and IL-6, and tumor necrosis factor (TNF)-α, which are the primary regulators of inflammation and apoptosis. This will trigger the release of various inflammatory molecules, including other cytokines and chemokines, and may play a role in the molecular pathological mechanisms of KC. These include the induction of oxidative stress and inflammation, along with ECM degradation. Alterations in some of these immuno-inflammatory parameters and proteins have been correlated with disease severity, allergy, eye rubbing, keratometry changes, and pachymetry measurements.