“There are none so blind as those who will not see.” — Jonathan Swift
Few quotations capture the constitutional tragedy unfolding behind Adiala’s walls with greater precision. At the centre of this crisis is, first and foremost, the serious loss of vision suffered by Imran Khan in one eye whilst in state custody. The tragedy is that a prisoner repeatedly complains of deteriorating eyesight, yet access to trusted physicians remains denied.
Medical treatment proceeds through delay, opacity and arbitrary administrative control. Family members remain deprived of contact. While one man gradually loses his vision inside a state prison, serious concerns regarding custodial mistreatment continue to arise before the courts; however, meaningful constitutional intervention from the judiciary remains absent.
Alongside the deterioration of Imran Khan’s eyesight stands another dilemma: the growing indifference of a judicial order. Judges can see reports of custodial mistreatment, denial of medical access, opacity and executive excess placed directly before them, yet continue to respond with hesitation and deference to administrative discretion.
The conduct of prison authorities may raise grave questions of abuse, but the deeper anxiety for any constitutional democracy emerges when courts appear reluctant to exercise their role as ultimate guardians of fundamental rights. When ocular injury unfolds openly before the judiciary and meaningful intervention still remains absent, the impairment ceases to be medical alone. It becomes judicial.
For months, alarming concerns have emerged regarding Imran Khan’s deteriorating health while incarcerated at Adiala Jail. His family has repeatedly complained that access to him is nonexistent. His legal team has been prevented from meeting him.
Personal physicians who had previously been permitted visitation were suddenly denied access without a meaningful explanation. Information concerning his medical condition has either been withheld altogether or selectively leaked through unofficial and filtered channels, thereby deepening public suspicion regarding the transparency of his treatment.
Then came the disturbing revelation that Imran Khan had suffered serious damage to the vision in his right eye. According to the amicus report submitted before the Supreme Court, Imran Khan had repeatedly complained for months of blurred vision. Those complaints were met not with urgent specialist intervention but with delay, indifference and superficial treatment.
A prisoner, deprived of liberty and dependent upon the state even for medical treatment, stands at the highest threshold of constitutional vulnerability
Eventually, he suffered catastrophic visual impairment. By the time specialist treatment was reportedly undertaken, he had been diagnosed with central retinal vein occlusion (CRVO), a serious vascular condition involving blockage of blood circulation within the retina due to clotting. It must be remembered that this is not a minor prison complaint. It is a grave medical emergency requiring urgent specialist care and investigation into the underlying causes of clot formation.
Blindness caused by delayed treatment inside state custody is not merely a medical matter; it raises profound questions regarding custodial responsibility and state accountability. When a prisoner repeatedly complains of deteriorating eyesight and those complaints allegedly go unanswered until permanent damage occurs, the issue transcends criminal negligence. It enters the realm of constitutional failure. A prison cell cannot become a zone where fundamental rights are suspended by administrative convenience.
Despite the seriousness of the condition, the response of the judiciary has appeared profoundly inadequate. The Islamabad High Court constituted a medical board comprising individuals who had already previously examined Imran Khan. It declined to order his transfer to a reputable private hospital. It failed to provide meaningful relief regarding access to his trusted physicians and family members. Most remarkably, it reduced the matter largely to one of executive discretion under prison regulations. This was not judicial restraint. It was judicial surrender.
The duty of constitutional courts is not to stand aside while fundamental rights deteriorate behind prison walls. The judiciary exists precisely to intervene when executive power threatens constitutional guarantees. Courts are not passive spectators to medical injuries. They are entrusted with the solemn obligation of preventing the abuse of state power, particularly where the individual stands entirely vulnerable before the machinery of the state. A prisoner, deprived of liberty and dependent upon the state even for medical treatment, stands at the highest threshold of constitutional vulnerability.
Article 9 of the Constitution guarantees the right to life. Article 14 guarantees dignity. Over decades, Pakistan’s superior courts have repeatedly held that the right to life includes proper medical treatment, humane care and protection against degrading treatment. The law is absolutely clear: prisoners do not forfeit their fundamental rights merely because they are incarcerated.
Indeed, incarceration imposes an even greater constitutional burden upon the State. Once liberty is taken away, the prisoner becomes entirely dependent upon the authorities for safety, treatment, medicine and survival itself. The right to consult a doctor of one’s choice is inseparable from bodily autonomy, informed consent and dignity.
It is the blindness of the judiciary towards an administrative system that believes imprisonment authorises secrecy
Pakistan’s obligations in this regard do not arise solely from its own Constitution. The United Nations Standard Minimum Rules for the Treatment of Prisoners, ratified by Pakistan and universally known as the Mandela Rules, require that prisoners receive timely access to necessary medical treatment, independent clinical judgement, specialist care where required, and treatment equivalent to that available to the general public.
Imran Khan is not seeking exile. He is not demanding immunity. The request is extraordinarily modest and within the ambit of the above-discussed legal parlance: transparent treatment, access to trusted physicians, meaningful family contact, and specialised medical care within Pakistan itself. These are not privileges. They are the minimum standards of humane custody under any constitutional democracy worthy of the name.
The Islamabad High Court relied heavily upon Rule 197 of the Prison Rules, treating transfer to a private hospital as a matter falling within executive discretion. But constitutional rights cannot be defeated by administrative regulations. A prison rule cannot override the Constitution itself. More importantly, the Court itself acknowledged that concerns regarding the adequacy of Imran Khan’s treatment “cannot be said to be entirely unfounded”. That single sentence exposed the contradiction. What, then, was the purpose of judicial authority if not to protect a prisoner whose health was visibly deteriorating in state custody? What is the purpose of constitutional jurisdiction if courts refuse to exercise it at the precise moment fundamental rights are endangered?
The deeper issue here, however, is not only medical negligence but also opacity. Why were trusted physicians denied access? Why have family members been prevented from meeting him for extended periods? Why were medical reports not transparently shared? Why was treatment conducted in secrecy? Why was Imran Khan transported to PIMS Hospital during the night without prior information being conveyed to his family? These are not political questions. They are constitutional questions demanding transparency. Wherever the state insists upon unchallengeable control over information, suspicion naturally follows — and rightly so.
One sees echoes of a larger constitutional tragedy here. A seventy-three-year-old prisoner repeatedly complains of deteriorating eyesight. His doctors are denied access. His family remains uninformed. Medical procedures allegedly occur in secrecy. And while one eye loses vision, institutions that were constitutionally obligated to act continue to look away. That is the true symbolism of judicial apathy: a judiciary that can still see brutal violations of fundamental rights but has failed to act with clarity. The injury, therefore, now extends from the waning vision of a single prisoner to the constitutional vision of the judiciary itself.
Pakistan now stands dangerously close to a condition where there exists not only the loss of sight in one eye of Imran Khan but a second blindness: the blindness of the judiciary itself. The real blindness behind Adiala’s walls is not confined to one damaged eye. It is the blindness of institutions — particularly the courts — that no longer appear willing to see constitutional rights as binding limitations upon power.
It is the blindness of the judiciary towards an administrative system that believes imprisonment authorises secrecy. It is the blindness of the judiciary towards an administrative system that denies access to trusted physicians, restricts meetings with family members, withholds medical information and yet continues to invoke the language of legality.
There are moments when constitutional courts must rise above regulatory technicalities and act with courage and clarity. This is one such moment. The question before the courts today is ultimately simple: can the state imprison a political opponent and then exercise effectively unchallengeable control over his body? Judges must remember that the moment administrative convenience begins to triumph over judicial discretion, the judicial arm of the state begins to decay from within. And the judiciary does not collapse all at once. It loses vision gradually until the judicial order itself becomes wholly blind.