Keratoconus can significantly impact one’s life, so answering this question is extremely important for peace of mind.
The speed that keratoconus can progress is unique to the individual. What is normal is that keratoconus usually begins during puberty and will usually progress at its quickest up to 25 years of age. Typically one eye is worse than the other.
Ideally, as soon as keratoconus is diagnosed it is important to have frequent follow up to monitor for progression. Some people will progress very slowly and will only ever need to wear glasses or contact lenses [2] , while others will progress quickly so a procedure called collagen crosslinking [3] needs to be considered.

Keratoconus is genetic and also seems to be associated with allergies and itchy eyes. It is imperative that the itchy eyes are treated, as keratoconus progression can be accelerated from excessive eye rubbing. Progression also seems to be associated with inappropriately fitted contact lenses. This is probably because the lenses rub on the diseased part of the cornea. It therefore is important to see an optometrist that specialises in difficult to fit eyes, if one wants to minimise their risk of keratoconus progression.
Footnotes
[1] The Critical Things You Must Know
[2] RGP, Hybrid, Piggy Backs Lenses
[3] Collagen Cross Linking