Keratoconus is a bilateral non-inflammatory ectasia of the cornea and the presentation is usually as an isolated condition. A few ocular and a number of systemic associations have been described. Situs inversus of retinal vessels is a rare developmental anomaly due to anomalous insertion of optic stalk into the optic vesicle. In this case report, we describe an unusual association of keratoconus with situs inversus and micronystagmus in a young man. An additional feature, a blue dot cataract, was also present. To the best of our knowledge, such a conglomeration of multiple ocular features has not been described previously.