The idea of starting community eye care in NWFP, Pakistan, was conceived in August 1987 in the holy city of Makkah, Saudi Arabia when Professor Dr. Mohammad Daud Khan and Dr. Mohammad Aman Kahn were both there to perform Hajj. In 1988 Dr. Mohammad Aman Khan received training in Community Eye Health at the International Centre for Eye Health (ICEH) London with the support of Sight Savers International (SSI), UK. On his return to Pakistan, Dr. Mohammad Aman immediately became involved in the first major community eye care assignment; a population-based survey to determine the prevalence, causes and regained distribution of blindness in NWFP and the Federally Administered Tribal Areas (FATA), Pakistan. The survey was sponsored by the World Health Organization as part of its Pakistan Prevention of Blindness Programme.

Dr. Aman’s next assignment was the establishment of a small Centre for Community Eye Health at the Department of Ophthalmology, Post Graduate Medical Institute, Lady reading Hospital, Peshawar.

This centre was established with the financial assistance of SSI in collaboration with the Health Department of Govt. of NWFP. In addition to offering training to doctors and paramedics, it actively contributed to the preparation of the Pakistan National Eye Care Programme for the prevention of blindness. The main thrust of this programme was:

	Strengthening the eye departments of District Headquarter and Agency Headquarter Hospitals.
	Extending eye care to Tehsil Headquarter (THQ) hospitals or to sub-district level for a defined population of 200,000 to 250,000 people.
	Initiating and integrating Primary Eye Care into Primary Health Care.

The centre for Community Ophthalmology at Lady Reading Hospital carried out a basic research to identify the obstacles in providing eye care at district level. A concept was developed and tested in a teaching hospital providing infrastructure, appropriate human resources and necessary instruments/equipment in a small operation theatre. The number of surgeries increased to 1200 per year.This concept of strengthening an eye department in a District Headquarter hospital as an integral part of District Health Care was piloted in District Bannu in 1994-95. The partners were Pakistan Institute of Community Ophthalmology (PICO), Health Department Govt. of NWFP and SSI, UK.

SSI evaluated this District Comprehensive Eye Care programme in 1997 (Link to this evaluation report). The evaluation report was positive and evaluation team recommended the replication of this programme in other districts country.

The centre started a one year training programme for ophthalmic technicians in 1993, with the financial and technical assistance of SSI and Christoffel Blindenmission (CBM), Germany. The initial focus was retraining of leprosy technicians in NWFP and re-designating them as Leprosy Ophthalmic Technicians.The centre then began examining ways of strengthening the concept of Community ophthalmology, both within Pakistan and within the wider region.In the meantime a number of recommendations came out from the World Health Organization, EM region, the World Health Organization headquarters in Geneva and International Agency for the Prevention of Blindness (Eastern Mediterranean Region) regarding the establishment of a higher-level qualification in Community Ophthalmology in this region.

The PICO was thus established with a mandate to start a one year long course in Community Ophthalmology with MSc from University of Peshawar. This was done with the help of SSI and CBM, and in collaboration with the Health Department, Government of North West Frontier Province, Pakistan and International Centre for Eye Health, Institute of Ophthalmology, London, United Kingdom.The Institute has a local, national and international faculty and with a well- designed curriculum and well-defined learning objectives. It is engaged in the following activities.