Keratoconus is a condition that causes progressive thinning and anterior protrusion of the cornea. Because of its irregular astigmatism, mild to moderate keratoconus is corrected with hard contact lenses (HCL), but blepharoptosis due to long-term wear is often a problem. In this study, we investigated blepharoptosis in hard contact lens wearers with keratoconus. Thirty seven keratoconic eyes were enrolled and divided into several groups according to their wearing history or age. Eyelid margin distance (EMD), margin light reflex distance-1 (MRD-1) and eyelid elevator muscle function were measured by ruler or anterior segment optical coherence tomography. EMD decreased with years of HCL wear but showed no correlation with age; MRD-1 decreased with years of wear and with older age; LF showed no relationship with either years of wear or age. In the classification of ptosis, there was no severe ptosis in the present sample. Long-term wear of HCLs is likely to cause blepharoptosis even in keratoconic eyes, but its degree may be mild.