Do you think an optometrist would miss keratoconus?

Possible: Any one can "miss" keratoconus, especially if it is in the early stages. It is often asymptomatic and not diagnosed until it affects your vision. A doctor would need to do extra testing to really make the diagnosis including corneal topography. This test is not routinely done--so it depends on the clinical presentation of the patient.

Keratoconus: In the early stages of keratoconus - the cornea looks normal and the vision can also be pretty good. The only way to make the diagnosis is with a corneal topography, but this is not performed routinely. Rather - topography is typically performed only when one suspects a corneal problem. Thankfully, corneal collagen cross linking is available - it stops keratoconus progression.