PUNJAB INSTITUTE OF PREVENTIVE OPHTHALMOLOGY
Prof. Dr. Asad Aslam Khan (Sitara-i-Imtiaz) M.S. (Ophthalmology) Director Punjab Institute of Preventive Ophthalmology

BRIEF HISTORY AND INTRODUCTION

Punjab Institute of Preventive Ophthalmology was established in 2004 to eradicate preventable & curable blindness from the country and from the province of Punjab, in particular. This is the fifth such Institute in the world & the second in Pakistan. It is attached with King Edward Medical University Lahore and the courses are approved by University of the Punjab and Punjab Medical Faculty. The Professor of Eye Unit III will also be ex officio Director General of Punjab Institute of Preventive Ophthalmology (PIPO). The teaching and non-teaching staff of Eye Unit III will also be the staff of PIPO & vice versa.

Building of PIPO

Location

It is situated adjacent to the clinical Ophthalmology Department
Building Plan
Building has 5 storeys, which include Offices, Classrooms, Auditorium, Conference Room, Computer lab, IOL Bank, Corneal Bank, Pharmacy for LPED, Male & Female Hostels

Sitting R To L :, Dr. Tehseen Mahmood , Dr. Ashaal K. Pal, Prof. Dr. Asad Aslam Khan, Dr. Raza Ali Shah, Dr. Shakil Ahmed,
Standing R to L Ist row, Dr. Iram , Dr. Nasira Inayat, Dr. Saira , Dr. Saroona , Dr. Sana , Dr. Junaid Afzal
2nd row, Dr. Saad Dil Mirza , Dr. Javaid Iqbal , Dr. Abdul Shakoor , Dr. Abdul Bari , Dr. Tahir Mehmood ,
3rd row, Dr. Nasir Chaudry, Dr. Nisar Jandan, Dr. Imran Ahmad, Dr. Azam, ,

TEACHING PROGRAM

Postgraduate:

i) Training/ Refresher course for Ophthalmologists in Childhood Blindness, Cataract, Glaucoma, Squint, Diabetes-related blindness and Diagnostic Ophthalmology.
ii) B.Sc (Hon) programme in Optometry, Orthoptics & Ophthalmic Technology

Undergraduate:

i) B.Sc. Vision Sciences (Refractionist) programme.
ii) Ophthalmic Technician Training Programme
iii) Ophthalmic Nursing diploma courses to be started this year

Research Projects:

i) Prevalence of Childhood blindness in Narowal & Sheikihupura Districts
ii) Estimation of Burden of Trachoma in 3 villages of Sheikhupura District (Pilot study)
iii) Pilot project to study multiple childhood disabilities in school children
iv) Prevalence of refractive errors in School children
v) Cystic Orbital Lesions in children
vi) Systemic association in Normal Tension Glaucoma
vii) Orbital Lesions in adults
viii) Pattern of ocular growth in children after cataract extraction
ix) Visual outcome and complication in suture less manual SICS
x) Role of intracameral injection of NSAID (Diclofenec Sodium) in reducing immediate post operative anterior uveitis after cataract extraction with phaco IOL
xi) Post operative uveitis in children with congenital and developmental cataract with ECCE and PCIOL with and without posterior capsulotomy and with anterior Vitrectomy
xii) Pattern of different types of Glaucoma in Patients attending Glaucoma Clinic in Mayo Hospital Lahore.
xiii) Causes and Management of Proptosis in children
xiv) Role of intracameral dexamethasone in preventing immediate post operative anterior uveitis in paediatric cataract extraction
xv) Orbital lesions in children
xvi) Effectiveness of MMC intraoperatively in DCR surgery
xvii) Role of Prostaglandin analogues in failed TRAB cases
xviii) Comparison of visual acuity & complications of early and late PPV for Vitreous haemorrhage
xix) Comparison of visual acuity & complications in Phaco VS Sutureless Manual SICS
xx) The anterior segment trauma ___its causes, management and visual outcome
xxi) Comparison of pattern of axial length growth in normal children and children after cataract extraction with IOL implantation
xxii) Pattern, Visual outcome and complications in different types of ocular trauma presenting to Mayo hospital Lahore.

FUNCTIONS & SERVICES OFFERED BY Punjab Institute of Preventive Ophthalmology (PIPO)

HUMAN RESOURCE DEVELOPMENT

1) Courses For Midlevel Eye Care Personnel:
One of the major objectives of Punjab Institute of Preventive Ophthalmology (PIPO) is development of Human Resource through training of Midlevel Eye Care Personnel (MLECP) to provide Primary Eye Care facilities at the grass roots level. To achieve this objective, the following courses were started at PIPO for which the admission process was completed by the end of 2004.
1) 4 – years B.Sc. (Hon.) Vision Sciences New
2) 3 – years B.Sc. Vision Sciences Courses
3) 1 – year Ophthalmic Technician training Course. ----- ALREADY RUNNING
2. The B.Sc. (Hon) Vision Sciences course is planned to cover all the aspects of the preventive ophthalmology over a period of 4 years. First two years are dedicated to teaching Basic Sciences & their application while third year is reserved for clinical internship. The candidates have the chance for specialization in the fourth year. The entry into Optometry, Orthoptics, or Ophthalmic technology course in 4th year will be determined by the result of 3rd year examination. Top 4 students will go to Optometry, Next 3 to Orthoptics & next 3 to Ophthalmic Technology course. The course is approved by University of the Punjab, which will award the degree of B.Sc. (Hon.) Vision Sciences degree to the successful candidates

Another course is three years B.Sc. Vision Sciences to produce Refractionists for the districts & tehsils level hospitals. Ultimately it is intended that Refractionist should be present at primary level of healthcare. This course is also approved by University of the Punjab, which shall endow the degree of B.Sc. Vision Sciences (Refractionist) to successful candidates.
The one-year Ophthalmic Technician-Training Course has been continuing at PIPO since 2001 & fourth such course shall start in 2005-06. The diploma for this course is awarded by The Punjab Medical Faculty.
Another plan in the offing is to start postgraduate Ophthalmic Nursing Diploma of two years duration.

2) Refresher Courses:
The Punjab Institute of Preventive Ophthalmology conducts refresher courses for Ophthalmologists of DHQ Hospitals in Cataract Surgery with IOL implant, Glaucoma, Childhood Blindness, Corneal-, Diabetes- related blindness & advanced Diagnostic Work up related to these disorders not only for the province of Punjab but other provinces as well.
3) Training of LHW’s and other paramedics in Primary Eye Care:
Training of Lady Health Workers & paramedical staff in upgraded districts for Primary Eye Care is being carried out continuously.

(B) DISTRICT COMPREHENSIVE EYE CARE PROGRAMME (DCECP)
This programme was introduced after the situational analysis in 1999 revealed that the ophthalmology departments of most of the DHQ Hospitals of Punjab were in very pathetic condition, all of them were lacking in quality equipment & that the surgical rate per year especially in cataract was far below than the required international standards set by WHO.
The programme has been launched with the help of international NGO’s like Fred Hollows Foundation (Australia), Aus-Aid, & Sight Savers International (UK). It includes:

1) Upgradation of Eye Departments of DHQ Hospitals:
As a part of District Comprehensive Eye Care Programme (DCECP) 17 DHQ Hospitals & 2 THQ hospitals were upgraded with the help of international NGO’s. New microsurgical equipment e.g. Operating microscope, Slit lamp, Biometer/ Keratometer, Autorefractor, Ophthalmoscope/ Retinoscope, Autoclave etc. & Computer for record maintenance was given to these districts & necessary changes in the building were undertaken. This was followed by celebration of eye week in the respective DHQ/THQ hospital with the help of donors.

2) Training/ Refresher Course of District Ophthalmologists:
The District Ophthalmologists of each upgraded district is given two weeks training at PIPO for latest surgical techniques e.g. cataract surgery with IOL implant, glaucoma, management of diabetic, corneal & childhood blindness.
3) Training of LHW’s and other paramedics in Primary Eye Care:
Training of Lady Health Workers & paramedical staff in upgraded districts for Primary Eye Care is also being carried out continuously.

(C) DISEASE CONTROL
1) Trachoma Survey:
A Participatory Rapid Appraisal (PRA) for trachoma was carried out in three villages of District Sheikhupura in 2004. A door-to-door survey was carried out which revealed 70 cases of active trachoma while 30 cases with trichiasis (cicatricial trachoma) were also found in these three villages with a combined population of about 5500

2) Establishment of Text Accessibility & Legibility Center (TALC):
This year Punjab Institute of Preventive Ophthalmology signed an MoU to establish a Text Accessibility & Legibility Center (TALC) for adults & children with low vision at Quaid-i-Azam Library Bagh-i-Jinnah & Children Complex Library with the help of Dark & Light Care, The Netherlands.

3) Registration for keratoplasty:
Punjab Institute of Preventive Ophthalmology intends to start transplantation of free corneas to the poor blind people. Registration for this purpose was started in 2004. In the meanwhile, negotiations with Nepalese Corneal eye banks for establishment of Cornea Bank at PIPO were started & it is hoped that very soon the first-ever corneal bank in the country shall be established at PIPO.
4) Outreach Activities:
Since its establishment in 2004, thirty- four (34) outreach camps have been conducted in different areas of Punjab. In these outreach activities, a total of 18604 patients were examined and 1018 free surgeries (cataract extraction with intraocular lens implant) were performed. Almost all the activities were conducted in Government hospitals/ Health Centers. These include camps conducted at Rangers Headquarters, Gurudawara Janamasthan Nankana etc.

(D) CONTINUOUS MEDICAL EDUCATION:

a) Workshops/ Seminars/ Trainings:
i) 1st Paediatric ophthalmology workshop - (A project of WHO/ Lions Club International Foundation) 29th to 31st December, 2004
ii) Workshop on Training of Master Trainers in Primary Health Care in Primary Eye Care (A project of WHO/ L.C.I.F.) 4th to 5th January, 2005
iii) Workshop/ Seminar on Comprehensive Eye Care for Punjab (In Collaboration with Aus-Aid & Fred Hollows Foundation Australia) 5th & 12th March 2005
iv) Workshop/ Training in Small Incision Cataract Surgery (In Collaboration with Fred Hollows Foundation Australia, Sight Savers International UK & Standard Chartered Bank) 13th to 16th June 2005.
v) 2nd Paediatric ophthalmology workshop - (A project of WHO/ Lions Club International Foundation) 14th to 16th November, 2005
b) Refresher courses for District Ophthalmologists
(E) AWARENESS CAMPAIGNS:
i.) World Sight Day Observed on 10th October, 2004
ii.) Press Conferences & Press Releases from time to time regarding various activities & achievements