A 33 year old medical doctor complained of bilateral gradual reduction of distant vision for the past 4 months. He was a known case of keratoconus and was referred to LV Prasad Eye Institute for further management. Following extensive examination, both eyes showed advanced keratoconus. With refraction, vision improved to 20/40 and 20/20 for the right and left eye respectively. Rigid gas permeable contact lenses trials were performed but were unsatisfactory. Then, customized hydrogel toric soft contact lens trials were done which improved the right eye vision to 20/25 and left eye to 20/20. Custom made hydrogel toric soft contact lens improved vision secondary to advanced keratoconus.