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An estimated 20,000-25,000 new cases of corneal blindness in India are worrying the doctors, who say untreated infections and injuries are the major causes. Corneal blindness is a significant cause of vision loss in the country, accounting for around 7.5 per cent of the total blindness burden.

According to experts, the major reasons for these eye disorders have shifted in recent years from infectious diseases like keratitis to eye trauma and other eye complications, “but the burden remains substantial, especially in rural areas where access to eye care is limited,” Dr. Smit Bavaria, cataract surgeon at Dr. Agarwal’s Eye Hospital, said in a news conference during the ongoing blindness awareness month.

Dr. Bavaria said keratitis progresses from mild irritation, redness, or vision impairment to severe scarring or opacity of the cornea, leading to partial or complete loss of vision if left untreated. However, treatment is most effective in patients who receive early intervention, especially those with infections or minor injuries that have not yet caused deep corneal damage. “Without timely treatment, many patients, particularly in rural or underserved areas, develop irreversible blindness,” he added.

Corneal blindness is a group of eye disorders that change the corneal transparency, leading to scarring and permanent blindness. Doctors say those targeted by corneal blindness can be as young as in their 20s and 30s. It is observed that symptoms of corneal blindness are accompanied by eye pain, light sensitivity, red eyes, and impaired vision.

According to Dr. Preethi Naveen, Senior Cornea and Refractive Surgeon, and Medical Director, at Dr Agarwal’s Eye Bank, important reasons behind the spike in corneal blindness numbers include deficiency of vitamin A and hygiene issues among people.

“India's high prevalence of corneal blindness is primarily due to infections like trachoma and keratitis, eye injuries in industrial and agricultural settings, and widespread vitamin A deficiency. Poor hygiene, delayed medical interventions, and limited access to healthcare, particularly in rural areas, further aggravate the problem,” she said, adding that even children are prone to this condition due to malnutrition and limited healthcare access.

According to Dr. Naveen, there are various diagnostic methods for corneal blindness, which include:

• A comprehensive eye examination
• Visual acuity testing
• Slit-lamp biomicroscopy

All of these allow ophthalmologists to assess corneal clarity and identify conditions like keratitis, ulcers, or scarring. “Advanced imaging techniques such as anterior segment optical coherence tomography (AS-OCT) and corneal topography provide detailed assessments of corneal thickness and surface irregularities, aiding in accurate diagnosis,” she said.

Experts say a definitive treatment of corneal blindness is corneal transplantation or corneal grafting. In this surgery, either part or the entire cornea is replaced by one that has been donated upon death by another person. However, doctors say an inordinate number of people still await corneal transplants due to the lesser number of eyes donated each year. “Despite efforts to promote eye donation and corneal transplantation, the demand for corneas significantly outpaces supply, with only 25,000 to 30,000 corneal donations annually against a need for 200,000 transplants,” said Dr. Sanjana Vatsa, Cornea and Refractive Eye Surgeon, Bengaluru, Dr. Agarwal’s Eye Hospital.

The most important directive for decreasing corneal blindness, therefore, is two-fold: promoting eye donation and transplantation, while at the same time, preventing corneal blindness by improving awareness about eye diseases and promoting timely interventions.

Also, according to Dr. Vatsa, there is a need to increase awareness and the importance of corneal donation through public participation, along with the implementation of programmes to address nutritional deficiencies, particularly vitamin A supplementation in vulnerable populations.

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