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Pakistan and China celebrated the 75th anniversary of the establishment of diplomatic relations on May 21. The events held around these celebrations underscore that the relationship between the two countries is entering a new phase characterised by greater financial integration, expanding sub-national cooperation and renewed geopolitical cooperation.

What began as a strategic and political partnership has gradually evolved into one of Pakistan’s most critical economic relationships. Today, China is one of Pakistan’s largest bilateral creditors, a major investor in infrastructure and energy, and an increasingly important source of financial stability for Islamabad during periods of economic stress.

Against this backdrop, Prime Minister Shehbaz Sharif is visiting China these days in a trip that focuses heavily on trade, industrial cooperation, financial connectivity and the future direction of the China-Pakistan Economic Corridor (CPEC).

“The visit is expected to further strengthen and deepen political trust, strategic coordination, expand political cooperation and consolidate the long-standing friendship between the two countries,” a Pakistan foreign ministry spokesman said at a weekly media briefing.

The growing engagement between Pakistani provinces and Chinese regional governments highlights how bilateral ties are extending at the sub-national level

The premier would begin his tour with a business-to-business conference and meet with the Chinese leadership, including President Xi Jinping and Prime Minister Li Qiang. “The two sides will review bilateral relations, and cooperation in political, economic and strategic domains,” the spokesman said.

Many in Pakistan believe that the geopolitical turbulence in the Middle East has created fresh opportunities for closer regional economic cooperation and alternative financing arrangements centred around China.

Foreign Minister Ishaq Dar’s visit to Beijing in late March amid Islamabad’s intensified diplomatic efforts aimed at easing tensions in the Middle East also underscored the two countries’ growing role as regional diplomatic actors. It highlighted Islamabad’s interest in aligning more closely with China on regional stability and economic security issues.

In that context, the recent issuance of overwhelmingly oversubscribed three-year Panda Bond reflects both economic necessity and strategic recalibration. The initiative has allowed Islamabad to raise yuan-denominated debt directly from Chinese investors, helping diversify its external borrowing sources at a time when access to international capital markets remains constrained and costly.

Therefore, Panda Bond is widely viewed as more than a financing instrument. It represents Pakistan’s broader effort to deepen integration with China’s financial system and reduce dependence on traditional Western financing channels. The recent crisis in the Middle East has further reinforced this thinking by exposing vulnerabilities in global trade routes, energy markets and international capital flows.

The strengthening relationship is also becoming increasingly diversified beyond the federal level. President Asif Ali Zardari visited China last month, where multiple agreements and memorandums of understanding were signed between Sindh and Chinese provincial authorities and businesses. The agreements covered areas ranging from trade and agriculture to urban development, technology and investment cooperation.

The growing engagement between Pakistani provinces and Chinese regional governments highlights how bilateral ties are extending at the sub-national level. Analysts view this trend as particularly significant because it broadens economic cooperation beyond large federal infrastructure projects under CPEC and creates new channels for investment, industrial partnerships and people-to-people connectivity.

At the same time, this renewed warmth in Pakistan-China relations is unfolding amid Islamabad’s parallel diplomatic outreach towards Washington and President Donald Trump. For Islamabad, however, managing this balance remains delicate. While Pakistan seeks stronger economic and diplomatic engagement with Washington, policymakers understand that such outreach cannot come at the expense of its long-standing strategic and economic partnership with Beijing. China remains indispensable to Pakistan’s economic stability, external financing and infrastructure ambitions in ways that few other partners can match.

Beijing’s concerns regarding the security of its assets and the safety of its nationals in Pakistan also continue to shape bilateral ties. Attacks targeting Chinese engineers and workers in recent years have emerged as one of Beijing’s biggest concerns regarding future investment expansion.

Pakistan has undertaken extensive security measures to address this issue. Significant progress has been made in improving the security environment for Chinese workers associated with CPEC and other ventures.

Nevertheless, Chinese investors continue to closely monitor the situation, and many believe more sustained efforts will be necessary if Pakistan hopes to attract larger volumes of Chinese private sector investment beyond state-backed infrastructure financing.

Financial cooperation between the two countries has, in the meantime, continued to expand steadily, though the balance remains heavily tilted in China’s favour.

Seventy-five years after diplomatic relations were established, Pakistan and China now find themselves navigating a rapidly changing global order together. The visit of Prime Minister Shehbaz Sharif, Pakistan’s entry into the Chinese capital market through the Panda Bond issuance, expanding provincial-level cooperation and increasing regional cooperation all point towards a relationship that is becoming more financially integrated, strategically consequential and economically diversified than ever before.

Published in Dawn, The Business and Finance Weekly, May 25th, 2026

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ISLAMABAD: The PTI confirmed on Sunday that Khyber Pakhtunkhwa Chief Minister Sohail Afridi and party chairperson Barrister Gohar Ali Khan had held a meeting with Interior Minister Mohsin Naqvi in previous days.

PTI Information Secretary Sheikh Waqas Akram told Dawn that the meeting was held to discuss the issue of terrorism in KP, especially in Bannu, where two police personnel and as many civilians were martyred while 25 terrorists were killed in a fierce clash between law enforcers, a peace committee and militants on Saturday.

The interior minister “mostly discussed how terrorism can be controlled”, he said.

He shared these details after Dawn approached him following an X post by Imran’s sister, Aleema Khan.

“Barrister Gohar and Sohail Afridi met Mohsin Naqvi. Our family had no knowledge of this meeting, and neither was any family member present,” she said, addressing another post that said she was also part of the meeting.

Speaking to Dawn, Akram also said, “It is incorrect that Aleema Khan was part of the meeting. Only the KP CM and Barrister Gohar attended the meeting, and it was regarding terrorist attacks in KP, especially in Bannu.”

Later, CM Afridi posted on X that the meeting was “regarding the terrorist incidents that took place in Bannu and the province’s law and order situation, and no political discussions took place in it that are being reported”.

Sources told Dawn that the meeting took place at Barrister Gohar’s residence.

A senior PTI leader, who spoke on condition of anonymity, said the meeting was held on May 14 at night, around 9pm.

“Sohail Afridi went to the venue along with his driver without a protocol vehicle,” he said.

When asked for more details of the meeting, he said one of the key areas of discussion was allowing incarcerated PTI founder Imran Khan to meet with his family and party leaders and providing him medical treatment at a hospital.

The Islamabad High Court (IHC) allowed Imran Khan to have twice-a-week meetings — on Tuesdays and Thursdays — with his family, lawyers and other associates. Despite the order, the former premier has been restricted from meeting visitors for several weeks.

Meanwhile, the PTI has also been demanding that he be shifted to Shifa International Hospital in Islamabad for treatment since his eye ailment — right central retinal vein occlusion (CRVO) — came to light in late January.

The senior PTI leader also said that during the meeting with Afridi and Gohar, Naqvi “made it clear the KP CM was not in the list of the favourite people”.

He recalled that previously, Imran had expressed annoyance when former KP CM Ali Amin Gandapur had held a meeting with Naqvi, a photo of which had been released.

Earlier this week, Afridi was also asked during a press conference whether he held a meeting with an “important personality”, to which he had replied: “I can meet anyone for Imran Khan.”

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ISLAMABAD: The Supreme Court has affirmed that imposing concurrent sentences in cases involving multiple murders substantially diminishes the seriousness of additional offences and artificially equates the taking of one life with the taking of several.

“To direct all sentences to merge into one concurrent term in cases of multiple murders would substantially dilute the gravity of the additional offences and create an artificial equivalence between the taking of one life and the taking of several,” observed Justice Muhammad Hashim Khan Kakar in a judgement he authored.

Justice Kakar, who headed a three-judge SC bench comprising Justice Salahuddin Panhwar and Justice Ishtiaq Ibrahim, heard a jail petition filed by Qaiser Abbas against a May 11, 2018, judgement of the Lahore High Court.

Qaiser Abbas was convicted of killing Faiza Bibi and Abiha on June 23, 2011. The prosecution stated a quarrel had taken place a month earlier between the deceased, Faiza Bibi, the complainant’s wife, and Shameem Bibi, the petitioner’s sister. Owing to this grudge, the victims were murdered.

Rules concurrent sentences in multiple murders undermine gravity of crimes

Following these allegations, Qaiser Abbas was arrested in the case (FIR828, dated June 23, 2011) registered at Allama Iqbal Town police station, Lahore. After a regular trial, the trial court convicted him on two counts under Section 302(b) of the Pakistan Penal Code (PPC) and ordered the two life imprisonment sentences to run consecutively.

At the outset of the hearing before the SC, Zulfiqar Khalid Maluka, representing the petitioner, said he was not contesting the conviction on merit.

Instead, the petitioner sought modification of the sentence so that the two life imprisonment terms would run concurrently rather than consecutively.

The counsel argued that the petitioner could not be sentenced to more than one life term in light of the bar contained in Section 35(a) of the Code of Criminal Procedure (CrPC). In support of his argument, he cited the 2009 Shah Hussain case, which bars sentencing an accused to more than a single life term in one trial under Section 35(a) CrPC.

Conversely, Additional Prosecutor General Muhammad Jaffer vehemently opposed the plea, arguing that the murders had been committed in the most brutal, savage and heinous manner possible. Therefore, he argued, the circumstances did not justify any leniency and the trial court’s decision to order consecutive sentences was fully justified.

In his seven-page judgement, Justice Kakar explained it is firmly accepted that punishment must remain proportionate to the seriousness of the offence. Proportionality requires that where multiple lives are unlawfully taken, each offence must receive independent penal recognition, he emphasised.

“In effect, such an approach risks conveying the impermissible impression that an offender may ‘kill two or three, pay for one’. The criminal justice system cannot permit a sentencing structure that diminishes the distinct value of each life,” the judgement observed.

The SC clarified that the doctrine of precedent under Article 189 of the Constitution requires all courts to adhere to the law laid down by the SC. However, it noted that the observation in the Shah Hussain case was made without noticing or overruling an earlier five-member larger bench ruling in the 1991 Bashir versus state case, which had already settled the interpretation of CrPC’s Section 35.

Thus, the judgment observed, the later observation in the Shah Hussain case, having been made without considering the earlier governing rule declared in Bashir’s case, could not displace it.

The SC explicitly ruled that the Shah Hussain case does not constitute a valid precedent and that the field continues to be governed by the Bashir case, which holds that proviso (a) to Section 35(2), CrPC, applies only to courts of limited sentencing jurisdiction, magistrates and assistant sessions judges, and not to sessions courts. Eventually, the SC held that it could not differ from the concurrent findings recorded by the courts below and found no ground to interfere in the impugned verdict.

Published in Dawn, May 24th, 2026

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KARACHI: Anmol alias Pinky, 31, an alleged cocaine queenpin arrested by police in Karachi, is ‘clever and street-smart’ because she did not hire anyone on a permanent basis in her narcotics trade, South Deputy Inspector General (DIG) Syed Asad Raza said on Saturday.

DIG Asad told Dawn that the accused Pinky’s associates supplied cocaine to customers through a network of 35 riders across the country.

“She started her own network in Lahore after ending a 10-year marriage with her husband, Rana Nasir, who was also an alleged drug dealer, accusing him of domestic violence,” the senior police official said.

He added that around nine or ten riders working for the accused had been arrested in Karachi’s Clifton and Defence areas.

“The accused hired lawyers and paid them fees to pursue the cases of the arrested riders. In addition, she remained in contact with different police officers,” DIG Asad said.

According to details shared by DIG South, Anmol told investigators that she had wanted to become a model since childhood, but her family had opposed her dream.

“To pursue her dream, one day she took a large amount of cash and gold ornaments from an apartment on Abul Hasan Isphahani Road. She informed her mother and moved from Karachi to Lahore in 2008 after having studied up to class 8,” he said.

Since she had no residence or relatives there, DIG South said, Anmol met a family who offered her a room on rent for Rs5,000 per month, where she stayed for one and a half years.

“In the meantime, she continued her efforts to work in films. She met a film producer who took her to different film shootings, but she could not get work in films. She also used to attend different parties with the producer and one day at a party in Lahore’s Defence area, she met Rana Nasir, who, according to her, appeared to be a wealthy man. She developed a friendship with him,” the official said.

“After eight to nine months of friendship, she married Rana Nasir at the age of 14 and started living in Defence, Lahore.”

During this time, DIG Raza said Anmol learnt that Nasir was an “international drug dealer”, who also allegedly used her several times for the supply of drugs and cash recovery.

“Rana Nasir also provided a Ufone SIM to her and opened an account with a foreign bank. He also arranged driving training and provided her with a car,” he said, adding, “The SIM and the bank account were used for narcotics trade.”

“Foreigners, particularly Nigerians, used to visit Rana Nasir’s home in Defence. They used to bring drugs to the house. Rana Nasir, as part of a well-planned strategy, used to hide the drugs to avoid arrest.”

Initially, the senior police official said, Anmol started supplying drugs along with her husband in Lahore, and later the husband started using her SIM to operate a network in Karachi as well, where she remained in touch with buyers.

Anmol told interrogators that her former husband, Nasir, used to purchase cocaine from Nigerians. Subsequently, he mixed chemicals to increase the quantity.

Later, DIG Asad said Nasir asked his three friends, who hired several riders to supply drugs to customers.

“Rana Nasir originally hailed from Gujranwala.”

Anmol said she witnessed the mixing of chemicals in cocaine and learnt the process. “On the directions of Rana Nasir, she also collected drugs from his friend Bobby several times.”

“Rana Nasir used her as a drug courier to supply consignments of drugs and recover payments from customers,” DIG South elaborated.

The senior police official further said some foreigners, particularly Nigerians, had been living in Nishtar Colony, Lahore.

“They were allegedly affiliated with drug cartels. They had married local women over the past five to ten years. They posed as clothes merchants but, under the guise of a textile business, they were supplying narcotics.”

After several months of marriage, the senior police official said Nasir started physically abusing Anmol.

“The couple did not have any children. After 10 years of marriage, she separated from Rana Nasir due to domestic violence and returned to her mother’s home in Karachi.”

She brought the same SIM which her former husband had provided to her, containing the names of all dealers, customers and riders, DIG Asad said, adding: “She started approaching them and within two to three months, set up her drug network.”

“She went to Lahore again and started working against her former husband, Rana Nasir’s network. She once again came into contact with her friend and drug supplier, Bobby.”

“Bobby initially provided drugs for supply in different cities,” the police official said.

“Since she had learnt a method of mixing chemicals into cocaine to increase its quantity from her former husband, she adopted the same method for selling cocaine in Karachi. Initially, she hired the services of a woman, Sabireen alias Sabira, who had a criminal record in Lahore, to supply drugs to Karachi from Lahore through local buses in return for Rs 50,000 per trip.”

The official said the accused also hired several riders in Karachi who originally hailed from Punjab; some of them had also been arrested in Karachi.

“After Bobby’s arrest, she obtained supplies from Kiran, one of Bobby’s friends,” DIG Asad said. “Later, she switched her supplier from Kiran to Anna.”

In the meantime, the senior official said the accused Anmol also involved her three brothers, Riaz, Nasir and Shaukat, in drug supply operations.

To avoid arrest by the police and other law enforcement agencies, the senior police official said the accused rented houses in Lahore’s posh areas, which she shifted frequently.

“During this period, she also approached Anna for the supply of cocaine. Anna’s husband was a Nigerian who was involved in the supply of cocaine. Anna began supplying cocaine via trains and private buses to Karachi in return for Rs60,000–70,000 per trip.”

Anmol told investigators that the chemical she mixed into cocaine was brought by her brother, Nasir, which increased the quantity of cocaine from 200 grams to 500 grams.

She elaborated that she experimented and made her “own brand” and sold it at Rs40,000 per gram, while low-quality cocaine was being sold at Rs20,000–30,000 per gram.

During her stay in Lahore, DIG Asad said Anmol developed a friendship with a police officer, Rana Akram.

“She was in a live-in relationship with the police officer,” he said.

“However, Anmol gave the impression of marrying the officer to avoid arrest by the police and other law enforcement agencies while continuing drug supply activities,” he said.

She told interrogators that she purchased several properties in the name of the police officer and also paid him substantial amounts of cash.

Investigators learnt that the police officer had earlier arrested Anmol but did not register a case against her. Instead, he developed a friendship with her and released her, and later both developed a mutually beneficial relationship.

DIG Asad said Rana Akram was posted in the Crime Investigation Agency and retired as a superintendent of police in January 2026.

He said Anmol had five main associates who worked for her in different roles.

“Anna used to provide her cocaine in its raw form and also worked as her drug courier for transporting cocaine from one city to another. Nasir used to procure chemicals and packing material for her from the market. Shaukat was the field operator responsible for the delivery of cocaine to customers. Zeeshan and Sohail were financial handlers of her drug trafficking network, who used to receive payments from customers and transfer the amounts to different accounts on Pinky’s instructions.”

These individuals transported cocaine between cities through local buses, he said.

“The entire network of drug trafficking was based on an online system.”

“Anmol used to receive orders directly from clients on her WhatsApp number and share bank account details for payment. Zeeshan would share screenshots as proof of payment,” said the DIG further.

“The cocaine was allegedly kept in a special box bearing her name.”

DIG Asad also revealed that 28 criminal cases had been registered against Anmol from 2018 to 2026, including five in Lahore from 2019 to 2024, 17 cases in Karachi from 2021 to 2026, and four new cases registered in Karachi in 2026.

“Her two properties in Gwadar and Karachi have been seized, while two bank accounts have been frozen.”

He added that Anmol had a total of 868 contacts. “Out of them, 383 mobile numbers were switched off, 311 were traced in Karachi, 49 in Lahore, 66 in other locations, 16 were international numbers, and two were suspended or incomplete.”

The police official also said that Anmol had employed a total of 35 riders. “Out of the 35 riders, 25 were arrested in Karachi between 2018 and 2026. Out of them, nine were acquitted, one was convicted, seven were remanded in custody, while four were on bail,” he said.

The senior police official further stated that the accused travelled from Karachi airport to Azerbaijan on December 25, 2018, and returned on January 4, 2019.

Talking about the extent of the investigation in Anmol’s cases, the DIG said police had established liaison with the Punjab Police and sent references to the National Cyber Crime Investigation Agency (NCCIA) for digital forensics and further support.

“References have also been sent to the Federal Investigation Agency (FIA) for bank transactions and account details, and money laundering investigations have been initiated at Karachi’s Commercial Banking Circle on May 18, 2026.”

“The police have also written to the Anti-Narcotics Force (ANF) and corresponded with the National Database and Registration Authority (Nadra),” he said.

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LAHORE: Actor and model Momina Iqbal on Friday filed an application with Chung Police for the registration of a first information report against a PML-N MPA Saqib Chadhar, levelling serious allegations of blackmail, harassment and death threats.

In her application, she alleged that the PML-N MPA had been making threatening calls to harass her and her fiance.

Momina claimed that the lawmaker turned abusive when she refused his marriage proposal, after it transpired that he was already married to two women.

Subsequently, she said Chadhar began blackmailing her. Momina also mentioned WhatsApp messages and video calls from the suspect in her application.

She further alleged that the the MPA also sent the same threatening messages to her sister’s mobile phone.

According to reports, Momina visited Chung Police Station along with her lawyers, met Station House Officer Faheem Imdad, and briefed him about her complaint.

Meanwhile, Punjab Chief Minister Maryam Nawaz also warned that any attempt to exert political pressure, abuse influence, or exploit a woman by threatening to release “personal content” in the case involving actor Momina and Chadhar would be met with “firm and uncompromising action.”

In an X post on Friday evening, the CM Maryam said the matter is a “personal issue” that will be “addressed strictly on merit and in accordance with the law”.

In an earlier social media post in which she tagged the PML-N leadership, Momina alleged that she had been subjected to “online harassment, cyberbullying and death threats for a long time.”

She claimed that both she and her family had suffered severe mental stress and trauma because of the alleged conduct of the MPA, whose identity she did not disclose publicly.

“A member of the provincial assembly belonging to the PML-N has been threatening me for an extended period. I repeatedly reported the matter to the National Cyber Crime Investigation Agency and the Federal Investigation Agency, but no action was taken,” she stated.

“Instead of ensuring justice, attempts were allegedly made to suppress my complaints. Even individuals associated with the office of the chief minister tried to discourage me and silence the issue rather than allowing a fair investigation,” she claimed.

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ISLAMABAD: PTI’s Islamabad wing held a protest in the federal capital on Friday despite Section 144 being in place, which restricts public gatherings.

It is worth mentioning that Tehreek Tahaffuz Ayeen-i-Pakistan (TTAP) and PTI had given a call to hold countrywide protests against former prime minister Imran Khan’s imprisonment, rising inflation and other issues on Friday.

The protest, held on Lehtrar Road near Taramri Chowk, was organised under the direction of PTI Islamabad President Aamir Mughal and led by General Secretary Malik Aamir Ali.

PTI Islamabad Senior Vice President Raja Sajjad Dhanyal, Women’s Wing President Maimoona Kamal, Youth Wing President Murad Bukhari, Insaf Students Federation representatives and other leaders and activists participated in the protest.

The protesters also demanded the release and proper medical treatment of the PTI founder and highlighted concerns over soaring inflation, deteriorating law and order, and the recent increase in petroleum product prices.

Mughal, speaking to Dawn, said they were aware that the federal police and other law enforcement agencies had made strict arrangements to prevent any kind of protest in the federal capital.

“Section 144 was already imposed in the federal capital, but we knew that we had to hold the protest as it was for founding chairman Imran Khan and against inflation, which has been badly affecting the masses,” he said.

“During the protest, we demanded that Imran Khan be released, inflation be controlled, petroleum product prices be reduced and the rule of law be ensured in Pakistan,” he said.

Mughal said that if the government did not address these issues, PTI would be left with no option but to launch a massive campaign and agitation after Eid.

PTI supporters also held a protest at the Peshawar Press Club. Speaking at a press conference, PTI’s Shandana Gulzar said the movement’s primary agenda was to secure the release of Imran and to stop the “bloodshed of innocent people” in the tribal districts of Khyber Pakhtunkhwa.

She alleged that innocent civilians in the province were being targeted in drone strikes and bomb blasts, claiming that women and children had also become victims of violence.

“There is unrest, inflation and insecurity across the country,” she said, adding that the province was being denied its due share of gas, electricity and other resources by the federal government.

Gulzar also criticised the federal and Punjab governments, accusing them of economic mismanagement and political victimisation of PTI workers and leaders.

She further claimed that living conditions had deteriorated to the point where families could no longer afford education or household expenses.

In Lahore, TTAP’s Punjab chapter staged a protest demonstration outside the Lahore Press Club in solidarity with the former prime minister and other political prisoners, demanding their immediate and unconditional release.

The protest was attended by political and social activists, including Pakistan Tehreek-i-Insaf (PTI) leader Shayan Bashir Nawaz, Mian Akram Usman, and leaders of the Haqooq-i-Khalq Party, including Ammar Ali Jan and Haider Butt.

The participants condemned what they described as increasing political repression in Punjab, citing heavy police deployment at the protest venue and alleged midnight raids on the homes of political activists a day earlier.

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WASHINGTON: Professor Rayaz Malik, a British-Pakistani scientist based in Qatar, says a simple AI-powered eye scan lasting just two to three minutes may soon help doctors detect dementia and diabetic nerve damage years before symptoms appear.

Professor Malik, a leading researcher in diabetic neuropathy and neurodegenerative diseases at Weill Cornell Medicine-Qatar, told Dawn that the technology could transform early diagnosis and treatment, particularly in countries with soaring diabetes rates such as Pakistan.

Speaking to Dawn, he explained how researchers at Weill Cornell Medicine are using this technology, known as corneal confocal microscopy (CCM), to identify nerve damage years before patients begin showing symptoms.

“The cornea has the richest sensory innervation in the body,” he said, explaining why the eye offers a unique window into diseases affecting the nervous system.

“We evolved to protect vision, so the cornea contains a dense network of nerves that can reveal damage occurring elsewhere in the body.”

Traditionally, CCM was used by ophthalmologists and optometrists to diagnose infections and abnormalities in the front surface of the eye.

But Professor Malik and his colleagues discovered that the same technology could detect microscopic nerve fibre damage linked to diseases far beyond the eye itself.

The breakthrough dates back to 2001, when he discussed the technology with Nathan Efron. At the time, Malik was studying diabetic neuropathy — a debilitating condition caused by nerve damage in diabetes patients.

“Many experts thought we were crazy,” Malik recalled. “But in 2003, we published the first paper showing corneal nerve loss in patients with diabetic peripheral neuropathy.”

That study opened the door to more than two decades of research.

Since then, investigators around the world have shown that CCM can detect nerve damage associated with diabetes, chemotherapy, inflammatory disorders and infectious diseases.

Research conducted in Qatar over the last 12 years has also demonstrated its ability to identify neurodegeneration linked to dementia, Parkinson’s disease, multiple sclerosis, schizophrenia and autism.

Professor Malik said one of the most significant applications of the technology lies in detecting dementia years before symptoms appear.

“When patients come to the doctor with memory loss and are diagnosed with dementia, the underlying nerve damage has usually been developing for 10 to 15 years,” he explained. “At that stage, treatments are largely ineffective.”

He said the challenge in modern medicine is identifying patients during the earliest phases of cognitive decline, known as mild cognitive impairment.

“MRI scans usually become abnormal only in advanced dementia,” Malik noted. “But we have shown that some people with mild cognitive impairment already have abnormal corneal nerves on CCM, and many of these patients develop dementia within five years.”

The implications could be particularly important for countries facing ageing populations and rising rates of neurological disease.

Professor Malik also highlighted the technology’s potential in diabetes care. According to him, diabetic neuropathy can be detected up to five years earlier through CCM scans.

“This is crucial because we now know that weight loss, controlling blood glucose, lowering lipids and reducing blood pressure can actually lead to nerve repair — especially when treatment begins early,” he said.

Artificial intelligence has dramatically enhanced the power of the technology. What once required lengthy manual analysis can now be processed in seconds.

“AI has been a game changer,” Professor Malik said. “When I look at a nerve image, I may identify three or four features. AI can analyse more than 2,500 features and learn patterns associated with specific diseases.”

He said AI systems can now identify the underlying neurodegenerative disease with 90 to 95 per cent certainty. 

In some studies involving diabetic neuropathy and Parkinson’s disease, researchers achieved nearly 100pc sensitivity and specificity.

Interestingly, he noted, the origins of both AI and confocal microscopy intersect in the work of Marvin Minsky, one of the pioneers of artificial intelligence at Massachusetts Institute of Technology, who also invented the confocal microscope in the 1950s.

Despite the promising results, Professor Malik acknowledged that widespread adoption has faced resistance.

“One major roadblock has been convincing neurologists that an endocrinologist could use an eye scan to diagnose neurological disease,” he said with a smile.

“Twenty-five years later, we have largely convinced them, although there are still some dinosaurs who refuse to believe — and we all know what happened to the dinosaurs.”

Another obstacle has been the limited availability of CCM machines. For years, only one German manufacturer produced the technology. However, Prof Malik said a Chinese company has now begun manufacturing new CCM devices, potentially making them more accessible and affordable worldwide.

That development could prove especially important for developing countries such as Pakistan, where diabetes rates continue to rise rapidly, and healthcare systems struggle with the burden of chronic disease.

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