SPECIAL REPORT  
Ophthalmological Society of Pakistan (OSP),  
Beyond 2016  
Mohammad Daud Khan1  
1Founder Vice Chancellor, Khyber Medical University, Peshawar  
This report highlights recent developments in OSP in  
the field of ophthalmic Medical Education including  
Professionalism, Research and Development,  
1. Where we were?  
2. Where are we now?  
3. Where do we need to go?  
4. How should we reach there?  
Publications and Eye Health Care service delivery  
system. In the year 2016, Prof. Ziaul Islam was elected  
as the new President of OSP. In the inaugural meeting  
of the central council, chaired by the newly elected  
Honorable President, it was observed that despite  
achieving major milestones since the birth of the  
country in 1947 and the birth of the Ophthalmological  
Society in 1957, there are still serious gaps in eye care  
in Pakistan in terms of equitability, cost, uptake,  
comprehensiveness, quality and sustainability.  
1. Where We Were?  
At the time of birth of Pakistan in 1947, Pakistan  
inherited 78 registered medical doctors and only few  
nurses. Health services in general and eye health  
services in particular were very rudimentary1.  
Apart from some eye care services at Mayo  
hospital Lahore aCivil hospitalKarachi and few  
cottage hospitals in Punjab, the rest of the population  
in the entire country was served by few Christian  
Missionary hospitals run by two very dedicated  
Missionary groups. Sir Henry Holland and his family  
covered the south, with two major facilities, one at  
Quetta for Baluchistan andthe other at Shikarpur for  
Sindh. Dr. Novel Christy and his associates served the  
North from their HQ at Taxilla.  
After detailed discussion, the Honorable President  
appointed a committee under the chairmanship of Prof.  
M.D.Khan with four terms of reference.  
1. Redraft OSP Vision, Mission and Values.  
2. Revamp and remodel the OSP Health and  
Education Foundation.  
3. Recommend SMART future plan to bridge the  
gaps.  
By 1950/60, new eye departments came up in  
public sector at Karachi, Multan and Peshawar. Few  
new eye departments were also opened in Military  
hospitals in major cities. However, 80% population  
had no access to organized eye care services2.  
4. Submit the report to OSP central council for  
thorough  
examination,  
adoption  
and  
implementation.  
The committee critically examined the issue and  
tried to find answers to four important questions.  
In response to a letter from Dr William John  
Holmes of Honolulu, on December 19, 1957, a  
meeting of ophthalmologists was convened in Lahore  
where the formation of Ophthalmological Society of  
Pakistan (OSP) wasapproved. Lt General Burki was  
elected as the Founder President and Professor Raja  
Mumtaz as thefirst secretary General of the  
Society.OSP was soon affiliated to APAO.  
How to Cite this Article: Khan MD. Ophthalmological  
Society of Pakistan (OSP), Beyond 2016. Pak J  
Ophthalmol. 2020, 36 (3): 197-204.  
Doi: 10.36351/pjo.v36i3.1082  
Mohammad Daud Khan  
Founder Vice Chancellor, Khyber Medical University,  
Peshawar  
Later on it was also affiliated to International  
Federation of Ophthalmological Societies, Afro-Asian  
Email: profmdkhan@gmail.com  
Pakistan Journal of Ophthalmology, 2020, Vol. 36 (3): 197-204  
197  
Mohammad Daud Khan  
Academy of Ophthalmology (AAAO), the American  
Academy of Ophthalmology (AAO), SAARC  
Academy of ophthalmology (SAO) and International  
Council of Ophthalmology (ICO)2,3.  
In 1979, the 7th APAO meeting was held in  
Karachi, Pakistan. The then President of Pakistan  
General Mohammad Zia-ul-Haq was invited as chief  
guest on this occasion. He took keen interest in the  
affairs of vision and its protection.  
Vision 2020: WHO/IAPB, the right to sight initiative.  
For implementation we followed the WHO six  
building blocks and the V.2020 threecore strategies;  
Disease control, appropriate Human resource  
development (HRD) and Infrastructure and appropriate  
technology development6.  
The program was developed incrementally in close  
collaboration of WHO and Sight Savers International  
(SSI). The concept was first tested in an artificial  
district in KPK, then in one real district (District-  
Bannu7) and finally in ten districts.8After thorough  
evaluation at each stage, it was finally rolled over to  
the entire country through two consecutive five years  
national eye health development programs.CBM, Fred  
Hollows Foundation and many other small  
organizations joined SSI, to support the project.  
Soon after this meeting in 1980, WHO country  
office invited Professor Hugh Taylor as WHO short-  
term consultant to report on the current status of eye  
health in Pakistan. The major findings of the report  
were;  
1. Prevalence of blindness in the country is over 2%.  
2. There are only 80 ophthalmologists to take care of  
a population of 100 million.  
The total cost incurred on developing 100 districts  
along with four provincial eye care HRD centers and  
the Pakistan institute of community ophthalmology  
(PICO) at Peshawar amounted to 13 Million USDs.  
The entire developmental cost was borne by the  
consortium of INDGOs6.  
3. 45 out of 64 districts are without ophthalmologist.  
4. There is no concept of eye care team.  
5. There is gross mismatch in human resource.4  
The report proved to be wakeup call for OSP and  
the entire country. OSP used the report as a major tool  
for Advocacy. The following steps were taken with the  
help of government of Pakistan, WHO and the  
International Non government Developmental  
Organizations (INDGOs).  
Large number of centers of excellence for Human  
Resource Development and sophisticated eye care  
interventions were opened in government and non-  
government sectors across the country. College of  
Physicians and Surgeons of Pakistan (CPSP),  
International Council of ophthalmology (ICO),  
London School of tropical medicine and hygiene and  
International Joint Commission of Allied Health in  
Ophthalmology (IJCAPO), played a key role in  
National committee for prevention of blindness  
(PBL) was notified in the late nineties.  
Prof. Saleh Memon, a highly talented, honest and  
upright ophthalmologist who was already working  
as a national coordinator since 1987/88 was  
appointed as the 1st chairman of the committee.  
training,  
evaluation  
and  
certification  
of  
ophthalmologists, community ophthalmologists and  
ophthalmic allied health personnel including  
ophthalmic nurses.  
The 2nd national blindness prevalence survey was  
undertaken in collaboration with London School of  
Tropical medicine and Hygiene and the INGDOs  
consortium in the years 2003 20049. The following  
were the salient features of the results of the 2nd  
survey.  
He succeeded in undertaking the monumental task  
of the 1stnational blindness prevalence survey in1987-  
88. The survey reconfirmed the findings of the WHO  
report, 1980.5In the early nineties, efforts were made  
to create an OSP Foundation to promote ophthalmic  
Research and Development and Ophthalmic medical  
education for all cadres and for all levels.  
The prevalence of overall blindness dropped from  
1.78% to 0.9%.  
Many senior Ophthalmologists and some members  
of the pharmaceutical industry played a key role in the  
financial support of this foundation.  
The number of ophthalmologists shot up from 80  
in 1980 to > 2000 in 2004.  
The number of cataract surgeries shot up from  
50,000 in 1980 to 500,000 in 2004.  
In 1994 Prof. M. D. Khan was appointed as the  
new chairman of Pakistan national PBL committee.  
District based national comprehensive eye care  
program was developed in close collaboration of  
The cataract surgical rate (CSR) shot up from  
1115/M in 1980 to 4000/M in 2004.  
198  
Pakistan Journal of Ophthalmology, 2020, Vol. 36 (3): 197-204  
Ophthalmological Society of Pakistan (OSP), Beyond 2016  
A mix of over 900 optometrists, orthoptists, over  
200 ophthalmic nurses and over 2000 ophthalmic  
technicians were added to the eye care human  
resource9.  
We face serious challenge of malnutrition;  
Stunting (45%), Acute under nutrition (16%),  
underweight (40%) and wasting (9%)13.  
We face serious challenges of air, food and water  
pollution and contamination.  
The result of the Pakistan 2nd National blindness  
prevalence survey was announced in Geneva in 2004.  
On the same day, the results of Indian and Bangladesh  
blindness prevalence surveys were also announced.  
The result showed that Pakistan had achieved the best  
results. At this moment of great joy, the Pakistan  
Health Minster, there and then announced to spend  
additional 46 Million USDs to further strengthen the  
Pakistan national eye health program.  
An estimated 70 percent of households drink  
bacterially contaminated water14.  
We have an unacceptably high rate of Road  
Traffic Accidents.  
We have high rates of drug abuse and also serious  
drug induced complications.  
We have poor control on unnecessary use or abuse  
of explosive devices.  
In 2006, Prof. Asad Aslam Khan was appointed as  
the new chairman of the national PBL committee.  
Our health care services are not truly integrated.  
Our primary health care system is very weak.  
Our school health system is dysfunctional.  
We have a very poor referral system.  
Prof. Asad Aslam Khan made significant  
contributions by strengthening all tertiary health  
care centers across the country.  
Our district health system needs to be further  
decentralized and strengthened.  
2. Where We Are Now?  
We are blessed with a very vibrant national  
ophthalmological society.  
Our tertiary care system is overburdened.  
We have to increase the centers of excellence and  
ensure its equitable distribution across the country.  
It is led by very competent and committed leaders.  
We have a strong national eye care network.  
We still have serious gaps in health care delivery  
through a strong and well-coordinated team.  
We have  
a
national HRD program for  
ophthalmologists, Ophthalmic subspecialists and  
Allied health personnel including nurses.  
Our health management systems are very weak.  
Our health services are neither comprehensive nor  
sustainable.  
We have centers for research and development and  
sophisticated eye care interventions.  
There is very little emphasis on Health Education,  
Disease prevention and Rehabilitation.  
We have strong national and international linkages  
and collaborations.  
We have a very strong national TV network, but  
there is not a single dedicated channel for public  
awareness, health education and health promotion.  
However, we still have some serious weaknesses  
and gaps in eye care systems.  
Our population is not only rapidly increasing; it is  
also aging. There is therefore, constant mismatch  
between the health care needs and supply.  
(37.54 M in 1950 & 220.039 M in 2020)10.  
Our literacy rate is still very low.  
(82.5% males, 59.8% females)11.  
3. Where Do We Need To Go?  
We have to generate some fresh data on the most  
common causes of blindness in the country.  
We have to come up with a health delivery system  
which is equitable, people friendly, integrated, of  
high qualityand comprehensive.  
Our maternal and infant mortality rates are  
unacceptably high. (Infant Mortality rate; 57.2  
deaths per 1,000 live births).  
We must ensure the availability of WHO six  
building blocks for any new health initiative,  
(Advocacy, user friendly Physical infrastructure,  
(Maternal mortality rate, 178 deaths per 100,000  
live births).12  
Essential  
human  
resource,  
Technology,  
Management and Collaboration.  
Pakistan Journal of Ophthalmology, 2020, Vol. 36 (3): 197-204  
199  
Mohammad Daud Khan  
management) and national and international  
collaboration to make eye care services  
Our Primary health care system must be changed  
to a strong family health care system.  
available,  
accessible,  
affordable  
and  
We must have a robust referral system.  
sustainable without compromising on quality.  
Our health care approach must be holistic and  
multidimensional. We therefore musttake on board  
the ministries of Population, Law, Environment,  
Water and Sanitation, Education and Disaster  
Management and Rehabilitations during the health  
policy formulation.  
3. Values:  
1. Lifelong commitment to service, quality care  
and compassion.  
2. Lifelong commitment to excellence in  
teaching, training and evaluation.  
3. Lifelong  
commitment  
to  
sustainable  
4. How Do We Reach There?  
institutional development and capacity  
building.  
The committee came up with following three  
important recommendations to achieve the OSP  
desired goals.  
4. Lifelong  
commitment  
to  
knowledge,  
scholarship, wisdom and creativity. (HRD  
with strong emphasis on Research and  
Development and CME, CPD & CED).  
1. Rename the Board. Call it OREEF (OSP Research,  
Education and Eye care delivery Foundation).  
2. Revisit and redefine the OSP vision, mission and  
values.  
5. Lifelong commitment to development of  
strong and courageous leadership with  
excellent skills in advocacy, communications  
and quality management.  
3. Constitute a management board assisted by five  
task forces to efficiently and effectively manage  
the board and achieve the society’s ultimate  
intervention goals.  
6. Strong team spirit with interpersonal  
relationships based on dignity, honor and  
mutual trust and respect.  
7. Equity and justice with passion to serve the  
un-served and underserved populations.  
A. OSP Vision, Mission and Values.  
1. Vision;  
8. Strong commitment to honesty, integrity,  
ethical values and professionalism.  
OSP will be a strong advocate and partner  
with Government of Pakistan and other  
national and international developmental  
agencies to promote eye care, prevent eye  
diseases and ensure provision and equitable  
distribution of high quality, integrated,  
comprehensive and Sustainable eye care  
services across the country so that nobody  
goes or remain blind because of lack, access or  
cost of services.  
9. Patience and perseverance with advance  
problem solving skills.  
10. Strong national and international linkages and  
collaboration.  
B. OREEF Management Board and the  
Five Task Forces:  
Prof. M. Lateef Chaudhry  
Chairman  
The society will try its best to ensure that  
those who are blind or suffer from severe  
visual impairment, get maximum medical and  
social services support to enable them to lead  
a life of full potential and good quality.  
Prof. M. Daud Khan  
Executive Vice chairman  
Prof. Shad Mohammad  
Secretary  
2. Mission:  
Prof. Hamid M. Butt  
Chairman Education & HRD  
OSP will take all necessary measures  
including strong advocacy, essential research,  
provision and access to necessary resources,  
Prof. Shahid Wahab  
Chairman R&D  
(money,  
manpower,  
materials  
and  
200  
Pakistan Journal of Ophthalmology, 2020, Vol. 36 (3): 197-204  
Ophthalmological Society of Pakistan (OSP), Beyond 2016  
Eight Members from Across the Country  
TORS:  
Prof. Mohammad Moin  
Chairman Publication Wing  
Come out with SMART strategies to adequately  
meet all the human resource needs in the form of  
an excellent eye care team, properly trained, well-  
motivated, well mixed and properly distributed to  
ensure integrated, high quality comprehensive eye  
Prof. Nadeem Hafeez Butt  
Chairman Fund Raising, Professionalism and  
Leadership Development  
Prof. Asad Aslam Khan  
Chairman, Eye Health Care Delivery and  
Management  
care delivery at all levels15,16  
.
Run all the affairs of the Task Force efficiently  
and effectively with honesty and integrity.  
Members; 14 from Across the Country  
TORS:  
Prepare strategic annual plan for Eye health  
education (with inbuilt mechanisms for monitoring  
and evaluation) in consultation of OREEF board.  
(Need, relevance (Eye Care Team) & quality).  
Generate, invest and manage funds efficiently and  
effectively.  
Prepare annual budget.  
Approve annual budget of the Foundation.  
Get the budget approved.  
Allocate money for research, publications and  
education.  
Ensure national and international Collaboration.  
Decide on the scope and purpose of Ophthalmic  
research and education.  
Prepare a comprehensive annual report for the  
board under the following heads.  
Prioritize areas of research and development in  
terms of society’s current and future emerging  
Needs.  
o
o
A: Internal & external Financial Audit Report.  
B: Internal and external Performance Audit  
Report.  
Ensure access, relevance and quality in education,  
research and patient care and treatment.  
o
C: Internal Quality Assurance Report.  
Ensure regular annual financial audit.  
Quality assurance across the board.  
2. Ophthalmic Research and Development.  
Chairman: Prof. Shahid Wahab  
Ensure strong coordination between Ophthalmic  
research, education, publication and health  
delivery and eye care management sectors.  
Executive Director: Prof. Mahfooz Hussain  
Eight Members from Across the Country  
Ensure strong national and international linkages  
and collaboration.  
Come out with SMART Strategies to  
adequatelymeet all the R&D needs of the society.  
Ensure efficiency of the foundation through  
excellent management systems.  
Run all the affairs of the Task Force efficiently  
and effectively with honesty and integrity.  
Performance audit of all relevant sectors,  
education, research and development, HRD,  
publications, health care delivery and eye care  
management.  
Prepare strategic annual Ophthalmic research  
implementation plan (with inbuilt mechanisms for  
monitoring and evaluation) in consultation of  
OREEF board.  
Generate an annual report for OSP central council.  
Ensure need, relevance, validity, quality and  
prioritization.  
C: The OREEF Five Task Forces:  
1. Ophthalmic Education (HRD).  
Types;  
Basics,  
Clinical,  
Epidemiological,  
Technological, Clinical Trials, Quality of Care and  
Quality of Life.  
Chairman: Prof. Hamid Mahmood Butt  
Executive Director: Col. Shahzad  
Prepare annual budget.  
Pakistan Journal of Ophthalmology, 2020, Vol. 36 (3): 197-204  
201  
Mohammad Daud Khan  
with government and non-government agencies at  
all levelsto ensure that;  
Get the budget approved.  
Ensure national and international Collaboration.  
1. the population’s current and future emerging  
needs in terms of access, cost and relevance  
are adequately met:  
Prepare a comprehensive annual report for the  
board under the following heads.  
o
o
Internal & external Financial Audit Report.  
2. The system is well integrated, equitable,  
sustainable and of high quality.  
Internal and external Performance Audit  
Report.  
3. It is efficiently connected through a robust  
referral system.  
o
Internal Quality Assurance Report.  
4. There is enough emphasis on health  
3. Publications  
promotion,  
disease  
prevention  
and  
rehabilitation.  
Chairman: Prof. Mohammad Moin  
Executive Director: Prof. Tayyaba Gul Malik  
Run all the affairs of the Task Force efficiently  
and effectively with honesty and integrity.  
Prepare strategic annual eye health care delivery  
and management plan (with inbuilt mechanisms  
for monitoring and evaluation) in consultation of  
OREEF board. (Needs, Rights, Relevance, Quality  
and Equitability).  
Eight Members from Across the Country  
Come out with SMART Strategies to meet the  
publication needs of OSP members, both  
quantitatively and qualitatively.  
Prepare annual Budget.  
Make all-out effort to attain the highest standard of  
the journal.  
Ensure national and international collaboration.  
Run all the affairs of the Task Force efficiently  
and effectively with honesty and integrity.  
Prepare a comprehensive annual report for the  
board under the following heads.  
Prepare strategic annual Ophthalmic research  
publication plan (with inbuilt mechanisms for  
monitoring and evaluation) in consultationwith  
OREEF board.  
A: Internal Financial Audit Report.  
B: Internal Performance Audit Report.  
C: Internal Quality Assurance Report.  
(Need, relevance, quality and strong ethical  
values).  
5. Fund Raising, Professionalism, Leadership  
Development and National/International  
Prepare annual Budget.  
Linkages and Collaboration.  
Get the budget approved.  
Chairman: Prof. Nadeem Hafeez Butt  
Executive Director: Dr. Qasim Lateef Chaudhry  
Ensure national and international Collaboration.  
Prepare a comprehensive annual report for the  
board under the following heads.  
Eight Members from Across the Country  
o
o
o
A: Internal Financial Audit Report.  
B: Internal Performance Audit Report.  
C: Internal Quality Assurance Report.  
Come out with SMART Strategies to adequately  
meet the OSP current and future emerging needs  
in the above mentioned areas with special  
emphasis on;  
4. Eye Health Care Delivery and Management.  
Chairman: Prof. Asad Aslam Khan  
o
o
Leadership development  
Promotion of ethics and professionalism in  
HRD, R&D and health care delivery system.  
Executive Director: Dr. Ali Ayaz Sadiq  
Negotiate with ministries of education, health and  
information to invest heavily in public health  
education, health promotion and disease  
Eight Members from Across the Country  
Come out with SMART Strategies to work closely  
202  
Pakistan Journal of Ophthalmology, 2020, Vol. 36 (3): 197-204  
Ophthalmological Society of Pakistan (OSP), Beyond 2016  
prevention through efficient utilization of all  
available media of information17,18  
robust referralSystem between all the three/four  
tier eye health care delivery system.  
.
9. OSP must have a strong national Leadership  
Development Program (LDP).  
Run all the affairs of the Task Force efficiently  
and effectively with honesty and integrity.  
10. Service delivery must be regularly monitored and  
periodically evaluated through an efficient  
management system.  
Prepare strategic annual plan for fund generation  
to adequately meet the task forces needs.  
Prepare annual budget.  
Get the budget approved.  
11. OSP must be a strong partner in the national eye  
care program. OSP therefore must ensure strong  
national linkages with;  
Prepare a comprehensive annual report for the  
board under the following heads.  
a. Government of Pakistan through Ministries of  
Health and Education, Pakistan Medical and  
Dental Council (PMDC), Pakistan Medical  
Research Council (PMRC), Higher Education  
Commission (HEC), National and Provincial  
Universities and College of Physicians and  
Surgeons of Pakistan (CPSP), the Civil  
Society, and the private and charitable health  
and educational institutions.  
A: Internal Financial Audit Report.  
B: Internal Performance Audit Report.  
C: Internal Quality Assurance Report.  
The OREEF Board will ensure that the Task forces  
come out with strategic plans to ensure that;  
1. All members of the foundation must have strong  
advocacy skills for negotiation with government  
and non-government developmental organizations  
for establishing equitable, sustainable and high  
quality patient friendly eye care services at all  
levels.  
b. International linkages and collaborations with  
institutions like WHO, UNICEF, British Royal  
Colleges, AAO, Regional ophthalmological  
societies,  
International  
Council  
of  
Ophthalmology, international universities and  
International Agency for Prevention of  
Blindness(IAPB) and  
2. The board needs to pay special attention to health  
education, health promotion and disease  
prevention.  
c. National and International non-government  
developmental organizations. (NGDOs  
INGDOs).  
&
3. The board also needs to pay very special attention  
to rehabilitate people with severe visual  
impairment and those who are blind.  
4. We make sure that the Foundation has enough  
funds to meet the annual needs of the task forces  
in a sustainable manner.  
D. Expected National Outcomes:  
Quality of Ophthalmic Medical Education for all  
cadres and for all levels will improve.  
5. All members of the eye health care delivery team  
are well trained, well-motivated, well mixed and  
optimally distributed.  
Relevance, validity, quantity and quality of  
ophthalmic research and development will also  
improve.  
6. Apart from necessary Knowledge and Skills, the  
curricula for all cadres must have ample  
opportunities for teaching, training and evaluating  
professionalism.  
High quality integrated eye care services will  
become accessible, affordable and sustainable.  
For People with marked visual impairment or  
blindness, strong rehabilitation services will  
become easily available, accessible and affordable.  
7. The board must ensure strong emphasis on all  
aspect of research and development in  
ophthalmology including quality of care and  
quality of life.  
Quality of patient carewill improves at all levels.  
Patient level of satisfaction will improve.  
High quality accessible eye care services will have  
a very positive impact on the quality of life of the  
affected individuals.  
8. All services must be integrated, people centered,  
comprehensive and sustainable. Primary care  
must be converted to family care. There must be a  
Pakistan Journal of Ophthalmology, 2020, Vol. 36 (3): 197-204  
203  
Mohammad Daud Khan  
Education and Social Welfare: Islamabad.  
8. National Program for Prevention of Blindness. 2nd Five  
Year Plan: 19992003. Ministry of Health, Special  
Education and Social Welfare: Islamabad.  
9. Jadoon MZ, Dineen B, Bourne RR, et al. Prevalence  
of blindness and visual impairment in Pakistan: the  
Pakistan National Blindness and Visual Impairment  
Survey. Invest Ophthalmol Vis Sci. 2006; 47 (11):  
4749-4755. Doi: 10.1167/iovs.06-0374.  
Prevalence and incidence of blindness and visual  
impairment will further drop down in Pakistan.  
High quality accessible eye care services will also  
have a very positive impact on national economy.  
Pakistan will become an epicenter for eye health  
tourism in the region.  
Pakistan will become a champion of WHO  
integrated; people centered eye health care  
(IPCEC).  
10. Pakistan population live available from:  
population/pakistan-population/[Accessed 9 June 2020]  
11. Federal ministry of education. Available from:  
[Accessed 9 June 2020]  
13. Healthcare in Pakistan. Available from:  
[Accessed 10 June 2020]  
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