This case relates the genesis and evolution of vision centres (VCs) for primary eye care at Aravind Eye Care System (AECS). AECS, based in the south Indian state of Tamil Nadu, is the world’s largest eye care provider. The case is based in 2014, exactly a decade after the first vision centre was opened, and evaluates the role of VCs in Aravind’s outreach ecosystem. Community outreach programmes were an integral part of Aravind’s model from the start and formed a central part of its vision of taking eye care to the community’s doorstep. For many years, community outreach at Aravind was done through eye camps held in remote rural locations. Eye camps had worked extremely well for a long time. However, eye camps were not a perfect solution to Aravind’s outreach goals for many reasons. Vision centres evolved as a way to address some of the shortcomings of eye camps, and both these outreach methods were employed in parallel. This case focuses on Aravind’s vision centres and how they evolved over a decade, how they compare with the eye camps as a vehicle to attain Aravind’s goals, and the opportunities and challenges ahead.