Ophthalmologists in Kerala have raised concerns that a shortage of high-quality donor corneas is undermining the state’s efforts to combat corneal blindness, even as public health institutions expand transplant capacity. Clinicians say the focus must now shift toward building robust Hospital Cornea Retrieval Programmes (HCRP) across both public and private hospitals to improve the quality and supply of donor tissue.
The challenge centres on the age of donor corneas. Corneal tissue from younger donors is considered more viable for transplantation, and the current supply is reportedly insufficient to meet growing demand. Kerala has invested in expanding corneal transplantation facilities in government hospitals, but without a parallel effort to strengthen eye donation systems, the infrastructure risks being underutilized.
What happened
Specialists in Kerala have flagged that the state, despite building out surgical capacity at government-run facilities, continues to face a shortfall of donor corneas suitable for transplantation. The concern is not simply the total number of corneas collected, but the age profile of the tissue available. Younger donor corneas are considered more viable for grafting, and the present supply is not adequate to meet rising demand. Ophthalmologists are now calling for a stronger, more systematic approach to eye banking, anchored in hospital-based retrieval rather than relying solely on voluntary donation drives.
Why it matters
Corneal blindness remains one of the leading causes of visual impairment in India, and Kerala has positioned itself as a model state for public health interventions. If transplant infrastructure continues to expand without a corresponding increase in usable donor tissue, the gap between the number of patients who need surgery and those who receive it will widen. The issue is also a question of efficient use of public spending: facilities built and equipped for corneal transplantation deliver limited public benefit if the supply of viable tissue cannot keep pace with surgical capacity.
Background and context
India’s broader effort to reduce corneal blindness has historically focused on expanding surgical access, particularly through government hospitals that offer treatment at low or no cost. While that approach has increased the number of transplants performed, eye banking infrastructure and donor coordination have not developed at the same pace. Hospital Cornea Retrieval Programmes, which identify potential donors within hospital settings and obtain timely consent from families, are widely regarded by specialists as the most effective way to secure high-quality tissue. Their success depends on trained grief counsellors, coordination between intensive care units and eye banks, and consistent protocols across institutions. Where HCRP systems are weak, reliance on voluntary eye donation camps tends to yield older tissue with lower cell density, which is less suitable for transplantation.
Kerala’s situation illustrates this tension. The state has expanded corneal transplant infrastructure within its public hospital network, but without a matching investment in retrieval systems, the supply of younger, higher-quality corneas has not kept up. The result is a mismatch between clinical demand and donor supply that specialists say is now reaching a critical point.
Analysis
Kerala’s experience reflects a structural challenge in India’s corneal blindness prevention strategy. The country has made significant gains in expanding surgical capacity, particularly through public health systems, yet eye banking infrastructure and donor coordination remain uneven across states. Strengthening HCRP systems has been identified by specialists as the critical bottleneck. These programmes require institutional commitment, trained personnel, and integration with hospital workflows, factors that cannot be addressed through awareness campaigns alone. Without sustained investment in donor tissue supply, expanded transplant facilities will continue to operate below capacity, and the gap between the population that needs treatment and those who receive it will persist.
What to watch next
The immediate question is whether Kerala’s health department will allocate dedicated resources to HCRP expansion, including training, counselling infrastructure, and coordination between government and private hospitals. Watch for any state-level policy announcements on eye banking reforms, new retrieval programme launches at district and taluk hospitals, and data on donor cornea age profiles published by the state’s eye banks. National-level developments, including any updates from the National Programme for Control of Blindness on eye banking standards, will also shape how Kerala and other states address the supply gap.
Conclusion
Kerala’s corneal transplant infrastructure is expanding, but the shortage of younger donor corneas threatens to limit its impact. Specialists have made clear that the solution lies not in building more surgical facilities, but in strengthening the systems that identify, retrieve, and deliver viable donor tissue. The coming months will test whether the state can translate clinical capacity into meaningful reductions in corneal blindness.
Sources
The Hindu: https://www.thehindu.com/news/national/kerala/why-shortage-of-young-corneas-is-hampering-corneal-blindness-prevention-drive-in-keralam/article71403686.ece
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Story synopsis gathered from: The Hindu – National — source
