Why in news?
The Indian Ministry of Health and Family Welfare has amended the Transplantation of Human Organs and Tissues Rules 2014. The change, notified on 6 November 2025, makes the use of a specular microscope optional for corneal transplantation centres. This reform aims to simplify infrastructure requirements and encourage more eye banks and hospitals, especially in rural areas, to perform cornea transplants.
Understanding the cornea
The cornea is the clear, dome‑shaped front surface of the eye that lies directly in front of the iris and pupil. It functions like a transparent window, letting light enter the eye and providing most of the eye’s focusing power. The cornea appears slightly wider than tall because the white of the eye (sclera) overlaps it at the top and bottom.
Structure of the cornea
- Corneal epithelium: The outermost layer, about five to seven cells thick, acts as a protective barrier and maintains a smooth surface for the tear film.
- Bowman’s layer: A thin, tough sheet of collagen fibres under the epithelium that protects the deeper stroma from injury.
- Stroma: The thickest layer (about 90 percent of the cornea) composed of collagen fibrils arranged in regular layers, giving the cornea its clarity and strength.
- Descemet’s membrane: A thin layer separating the stroma from the endothelium that thickens with age.
- Endothelium: A single layer of hexagonal cells on the inner surface that regulates fluid balance within the cornea. Damage to this layer can cause corneal swelling and vision loss.
Functions of the cornea
- Light transmission: Because it is transparent and curved, the cornea allows light into the eye and bends (refracts) it toward the lens and retina.
- Protection: Along with the eyelids and tear film, the cornea shields the inner eye from dust, germs and injury.
- Focusing power: It provides about two‑thirds of the eye’s focusing ability; the crystalline lens behind it provides the rest.
About the amended rules
- Specular microscope: This microscope is used to count and assess the health of corneal endothelial cells. Earlier regulations made it mandatory for transplant centres to have one, which posed a financial burden.
- Key change: The amendment revises Form 15 of the 2014 rules by replacing “Specular” with “Specular (optional)”. This makes the microscope non‑mandatory, allowing centres with limited resources to operate without it.
- Expected impact: By lowering equipment costs, more hospitals and eye banks in smaller towns and villages can become authorised corneal transplant centres. This could reduce waiting times for corneal grafts and restore sight to more patients with corneal opacity or injuries.
Conclusion
The cornea is essential for vision, and damage to this delicate tissue can lead to blindness. The policy change making specular microscopes optional aims to expand access to corneal transplantation across India, helping restore sight to many more people.
Sources: Times of India, Official Gazette (NOTTO), All About Vision