Can eye transplants cure blindness? Colorado doctors just got $46M of federal funding to find out.

Here’s an incomplete list of things that doctors are able to transplant from one human to another: a heart, a lung, a kidney, a liver, a pancreas, a face, a hand, skin, bone marrow, stem cells and blood.

But not eyes.

A team of scientists and doctors at the University of Colorado Anschutz Medical Campus hope to change that through groundbreaking work on whole eye transplants, and now they’ve scored a big investment from the federal government to help them do that.

“This is a transformative award, and it really gives us the opportunity to make incredible breakthroughs for vision loss,” said Dr. Kia Washington, a surgeon and scientist at CU-Anschutz who is one of the team’s leaders.

Innovative research, innovative funder

The money — up to $46 million over five years — comes from a federal health research funding agency known as ARPA-H, which was established in 2022 to shake up how the U.S. pays for innovation in medical sciences.

The federal government’s traditional funding model for health science involves giving grants to labs pursuing promising research and then seeing what comes of it. ARPA-H aims to act more like a venture capital firm, signing contracts — not grants — with researchers and giving them a set of goals to achieve, all overseen by a project manager at ARPA-H.

“The beauty of that is that we are under pressure to deliver,” Washington said.

They are also under pressure to collaborate, which is how Washington found herself in February at a gathering in New York City that was something like speed dating for scientists trying to cure blindness.

When ARPA-H tackles a big initiative — in addition to its funding on blindness, the agency is also supporting research in 20 other areas, including up to $39 million to a different CU-Anschutz team studying how to make joints heal themselves — it doesn’t want to pick just one approach. Instead, as Dr. Calvin Roberts, the project manager for the blindness initiative, put it, the agency wants “multiple shots on goal with different groups working at different strategies to accomplish the same outcome.”

And so at that speed-dating event, researchers formed teams to bid for ARPA-H support. The CU-Anschutz team includes scientists from seven other institutions at universities and foundations across the country. And the CU squad is one of just four teams nationally to receive ARPA-H funding to cure blindness — the others are headed by Stanford University, The University of Miami and InGel Therapeutics, a spinoff from Harvard.

All together, the total project involves 52 medical research institutions across the country receiving up to $125 million.

Even with that funding, progress toward a successful eye transplant or other cure for blindness could be slow or uneven.

How to transplant an eye

The challenges here are many. While cornea transplants have long been a thing, the cornea is just the window of the eye, not the entire organ. No one has ever successfully restored sight through an eye transplant.

That’s because an eye is, as Roberts puts it, “the anterior extension of your brain.” In other words, it’s a long offshoot of our most complexly wired organ.

“What you would need to be able to do to transplant an eye would be what you need to do to be able to repair a brain, to sever brain tissues, to reattach brain tissues,” Roberts said. “And we just don’t know how to do that.”

To restore sight through an eye transplant, you would need to take an intact eye from a deceased donor and reattach it — optic nerve and all — into a living patient. That requires an incredibly precise surgical technique, which Washington is working on.

Then you would need to keep the body from rejecting the new organ. Another lead CU researcher, Christene Huang, is studying how to do that without massively suppressing the immune system.

And then you have to figure out how to heal and regenerate the optic nerve so that sight can return, something that’s never been done before.

Washington said she foresees people who suffered traumatic eye injuries as likely the first candidates for eye transplants — and she’s also received some funding from the U.S. military with that in mind. People who lost vision due to disease may also end up being candidates.

But this is not something that will come quickly, Hauser said.

“It may not happen in the timeline of this award,” she said.

Opportunities for advancement

Even if it never happens at all, it could still greatly advance the science of transplants and other treatments.

For instance, if the team never figures out how to restore vision but does find better ways to keep the body from rejecting a transplanted organ, that would be hugely beneficial. Transplant patients now are at extreme risk of serious illness from common germs because of how heavily suppressed their immune systems are.

Learning how to heal the optic nerve could yield benefits for other injuries to the central nervous system.

“Those of us who work in the eye,” Roberts said, “what we love about working in the eye is that it’s just a model for things that are going on elsewhere in the body.”

Will this funding survive into the next presidential administration?

ARPA-H is an agency within the U.S. Department of Health and Human Services, which is poised for a shakeup, with both Republicans in Congress and the incoming administration of President-elect Donald Trump vowing big changes to how health science is funded.

So what might become of this project to cure blindness?

Asked that question during the press event this week announcing the CU-Anschutz award, ARPA-H director Renee Wegrzyn said she expects the work will continue. She noted that the agency has received $1.5 billion in appropriations from Congress and is hopeful that level of support will remain the same or increase.

“For the programs that are launched, we’re planning to go all the way through to the end, and we have those funds set aside to do that,” she said.

She also said announcement events like the one at CU-Anschutz are part of a strategy to make the case for continuing ARPA-H to a new administration and a new Congress.

“Days like today where we can talk about this really great, groundbreaking research with awards to really talented awardees … going forward is going to be critical,” she said.

Colorado U.S. Rep. Diana DeGette, D-Denver, also attended the announcement and vowed to fight for ARPA-H’s funding.

“I am committed after this election to working with my colleagues on both sides of the aisle, as we have done up until this point, to make sure that ARPA-H not just continues to exist, but also continues to exist as a robust institution in our medical research pathway,” DeGette said.