Corneal blindness cases continue to rise in India, experts call for targeted interventions

India is witnessing a rise in corneal blindness, with an estimated 20,000 to 25,000 new cases each year. Corneal blindness now accounts for about 7.5 per cent of the total blindness burden in the country. The causes have shifted over the years, with cases now more commonly stemming from eye trauma and complications rather than infectious diseases like keratitis. The burden remains particularly significant in rural areas, where access to eye care is limited, said Dr Smit Bavaria, Cataract Surgeon at Dr Agarwal’s Eye Hospital, Wadala, Mumbai, speaking during Blindness Awareness Month.

Keratitis, one of the conditions leading to corneal blindness, often progresses from mild symptoms such as irritation, redness, or vision impairment to severe corneal scarring or opacity if untreated. Early intervention can significantly improve outcomes, especially in cases where infection or minor injuries are caught before causing deeper corneal damage. However, patients in rural and underserved areas often lack timely access to care, leading to irreversible blindness.

Dr Preethi Naveen, Senior Cornea and Refractive Surgeon and Medical Director at Dr Agarwal’s Eye Bank in Chennai, remarked, “Corneal blindness is a significant cause of vision loss in India, affecting approximately 12 lakh 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 healthcare access, particularly in rural areas, further aggravate the problem.” Children and working-age adults in rural areas are particularly at risk due to malnutrition and frequent eye injuries, while elderly individuals face heightened risks due to degenerative eye conditions. Overall, an estimated 1–2 per cent of India’s population is at risk of developing corneal blindness, she added.

Diagnostic methods for corneal blindness in India include comprehensive eye examinations, visual acuity tests, and slit-lamp biomicroscopy, which allow ophthalmologists to assess corneal clarity and identify conditions such as keratitis, ulcers, or scarring. Advanced imaging methods, including anterior segment optical coherence tomography (AS-OCT) and corneal topography, offer detailed assessments that aid in accurate diagnoses. Corneal transplantation and other therapeutic interventions have proven successful in patients without complicating health conditions such as diabetes or immune disorders, according to Dr Naveen.

Dr Sanjana Vatsa, Cornea and Refractive Surgeon at Dr Agarwal’s Eye Hospital in Bengaluru, emphasised that accessibility and healthcare disparities remain significant challenges. “Many patients in rural areas lack access to quality eye care services, which often results in irreversible corneal damage before they seek help. Additionally, there is a substantial gap in training and resources for healthcare providers, limiting their ability to effectively manage and treat corneal conditions,” she said. A shortage of corneal donors is also a major barrier, with only 25,000 to 30,000 corneal donations each year against a demand for 200,000 transplants. Socio-economic factors, such as poverty and malnutrition, further increase the risk of corneal blindness, complicating efforts to implement comprehensive prevention and treatment strategies.

Dr Vatsa further highlighted the need for a multi-faceted approach to reduce the incidence of corneal blindness. “At the individual level, there is a need to increase awareness about eye health, encouraging routine eye examinations to identify and treat issues at an early stage. Launching initiatives focused on eye health education and the importance of corneal donation can increase public participation. Implementing programs to address nutritional deficiencies, particularly vitamin A supplementation in vulnerable populations, can reduce corneal-related issues,” she noted.

With these targeted interventions, healthcare professionals and policymakers aim to reduce the prevalence of corneal blindness and improve eye health across India.