Corneal Disorders
Last updated: 27th January 2026
Overview
The cornea is the thin, transparent layer of tissue shielding the eye’s surface and covers the iris and pupil. Corneal diseases and injuries can cause pain, redness, blurred vision, and even vision loss if untreated. The main cause of corneal disorders are infections, especially in India. The final stage of treatment may well be a corneal transplant.
Corneal opacity, the scarring and damage of transparent corneal tissue, is the main cause of blindness in India among those who are less than 50 years old. On those who are older, it is the second main cause of vision loss. In many parts of India, corneal transplant take weeks or months to schedule and execute. While there are no waiting times at LVPEI for a transplant, lifelong after-care is a critical area of interest.
What are corneal disorders?
The cornea is critical to the eye’s ability to receive light from the outside world. The cornea’s shape is ‘prolate’, it is steep in the centre and flatter at the ‘poles’; this allows it to bend and focus light into the eye. It is made of 5 layers of transparent tissue and any damage to them can impair vision.
A variety of corneal disorders are treated at LVPEI. The most common types include ocular surface disorders (like dry eye disease), accidents to the eye, corneal infections or autoimmune conditions that cause inflammation (keratitis), keratoconus, and congenital or genetic diseases (corneal dystrophies).
What is Pterygium?
Pterygium is the disruptive growth of the conjunctiva, the white part of the eye, on to the cornea. People who work outdoors and spend many hours in the Sun are susceptible to this condition. While this growth is benign (not cancerous), it can still irritate the eye and impair vision.
Pterygium is found across India, as it is in the tropics, especially amongst agricultural workers. A simple surgery can fix pterygium growth.
What are corneal infections?
Corneal infections are one of the main causes of corneal opacity and sight loss in India. From conjunctivitis on to more serious infections, different microbes can infect and damage the cornea. While bacterial infections are common, fungal infections too are now growing across India. At LVPEI, we have characterized a whole new organism, Pythium insidiosum, which infects the eye.
Pythium infections resemble a fungal infection, but anti-fungals don’t work on them [1]
A corneal abrasion can occur from a leaf or similar organic matter that grazes the eye, leading to an infection. If left untreated, the abrasion can lead to a corneal ulcer, which is painful and hard to treat. Ultimately, the ulcer may ‘melt’ the cornea, and the person may require a corneal transplant to be able to see again.
Trauma
Accidents and injuries—ocular trauma—is a key cause for corneal opacities. In India, there are several occupational hazards that lead to trauma. While agricultural work is a key cause of accidents, even workers in industrial settings who don’t use protective glasses are at risk. Chuna or quicklime damages the eyes of children who mishandle it [2]. Firecrackers during Diwali is another key cause of damage to eyes.
What are corneal dystrophies?
A ‘dystrophy’ is a faulty development of a tissue or organ. In the case of the cornea, a set of rare genetic diseases can lead to the buildup of organic deposits on the cornea. This ultimately leads to corneal ‘erosion’, which then leads to vision loss.
There are numerous corneal dystrophies and can affect the different layers of the cornea. For example, the most ‘common’ corneal dystrophy is the fuch’s dystrophy and women have a greater preponderance of risk for this condition.
What is a corneal transplant?
In cases of severe damage to the cornea, the only viable solution may be a corneal transplant. It is called a keratoplasty, and the surgeon replaces the damaged cornea with healthy corneal tissue from a donor. A successful corneal transplant can restore vision and relieve pain. While the procedure itself has a great chance of success, the true win is when the patient is able to maintain the transplant for a decade or more.
There are several kinds of corneal transplants. A ‘full thickness’ keratoplasty replaces the entire corneal tissue. An endothelial keratoplasty or a lamellar graft only switches a damaged sub-portion of the cornea.
Frequently Asked Questions
LVPEI specializes in the diagnosis and treatment of the full range of corneal conditions. To support corneal transplants, the Ramayamma International Eye Bank also collects and shares corneal tissue across the LVPEI network. We have performed over 50,000 corneal transplants since inception, making LVPEI one of the largest volume corneal transplant centres in the world.
An eye donation is actually just the donation of corneal tissue. On a person’s death, their corneas are retrieved, processed, and shared with eye surgeons who place them on patients with damaged corneas thereby restoring their vision. Read more at our eye banking section.
Corneal transplants have nearly a 90% success rate, but this rate begins to drop by the first year as people do not adhere to follow-up care. Periodic care and adherence to good practices are critical for the long-term viability of a transplant.
Damage to corneas because of chuna or occupational accidents are wholly avoidable. If there are abrasions, then quick and immediate trauma care can ensure that it does not progress to a corneal ulcer or worse. Genetic disorders are currently not preventable but their symptoms may be mitigated. In some cases, a macular corneal dystrophy for example, the outcomes of a corneal transplant are very good.
Graft rejection or failure are possible outcomes of a corneal transplant. In such cases, your surgeon may offer several options including a repeat transplant.