The mainly challenge for the treatment of BCS is relies on early diagnosis, which allows us to take prompt measures to prevent ocular rupture. Protective measures and disease education are most important, provided both protective spectacles and suitable education for patients, their parents, other caregivers and school staff about these and other lifestyle measures. Previous studies showed that patients at early diagnosis of BCS whom corneal perforation was averted by the use of special protective glasses [
5,
20]. For BCS patients, any reduction of central corneal thickness should be actively recommended to wear the protective glasses, but whether it is necessary to continuous use is not clear [
5]. At the early period of BCS, visual acuity often impaired by keratoglobus, keratoconus and high myopia [
23,
24]. The use of contact lenses is optional, however the efficacy of correction of the irregular astigmatism caused by keratoglobus and keratoconus is limited. Furthermore, the progressive corneal thinning is frequently restricted the use of contact lenses. In cases of progressive BCS, epikeratoplasty (A partial thickness corneal graft) has been used in prevention of corneal rupture, which objective to increase the thickness of limbus to limbus and allow a penetrating keratoplasty subsequently [
25,
26]. Additional corneoscleral grafting is the other option for extreme corneal thinning, which will not improve vision, but may reinforce the peripheral cornea [
27]. What’s more, lots of researches have demonstrated that collagen crosslinking was an effective approach in treating progressive keratoconus in children and adults [
28,
29]. However, because of the extreme thinning and frailty, the corneas in BCS patients were not suitable for a CXL procedure according to the original Dresden protocol [
30]. Recently, Claude K et al. used a modified collagen crosslinking for corneal stabilization in a child with BCS have achieved encouraging preliminary results [
31]. But only time will tell whether the collagen crosslinking can prevent the rupture of cornea or not.