The dual meaning of kerato- reflects its etymology: the Greek root keras (“horn”) was applied to the cornea because early anatomists recognized its tough, horn-like consistency — the cornea is indeed an avascular, dense, fibrous tissue similar in feel to compressed horn. In ophthalmology, kerato- refers specifically to the cornea — the clear, dome-shaped anterior surface of the eye responsible for about two-thirds of the eye’s total refractive power. In dermatology and histology, kerato- refers to keratin, the fibrous structural protein that is the primary component of the epidermis (outer skin), hair shafts, fingernails, toenails, and animal horns/hooves. Because keratin-producing cells (keratinocytes) make up ~90% of all epidermal cells, the kerato- root is extremely productive in dermatological terminology as well. Context is everything — if you see kerato- in an ophthalmology note, it refers to the cornea; if you see it in a dermatology note, it almost certainly refers to keratin or horny skin tissue.
In the eye, the cornea gets its name from Medieval Latin cornea tela (“horny web/sheath”), directly referencing its horn-like texture. It is the transparent, avascular anterior layer covering the iris and pupil, responsible for approximately 65-75% of the eye’s refractive power.