A corneal marking system and methods for its use, has a first tilt-detecting device attached to a corneal marker, adapted to produce a signal when the corneal marker is in a horizontal position. In another version, the first tilt-detecting device is adapted to produce a signal when the corneal marker is in tilted to a pre-selected value and a second tilt-detecting device is attached to the patient's head to measure the tilt of the head and is adapted to produce a signal when the head is tilted to match the pre-selected value of the first tilt-detecting device. In a third version, the first and second tilt detectors send signals to a signal detector which emits a signal when the first and second tilt detectors indicate substantially the same amount of tilt. In each case, the cornea is marked when the appropriate signal is emitted.