Aravind Eye Care System (AECS) exploited economies of scale to offer affordable eye care for masses, with a mission to eliminate needless blindness. Over the years, AECS had built a strong organisational culture based on compassion and service. The organisation had made its first foray into large metro cities by establishing a presence in Chennai in 2017 and was gradually scaling up when the Covid-19 pandemic erupted globally in March 2020. The precipitous decline in patient volume triggered questions on the survival of the business model, which was dependent on high volumes. The case details various challenges faced by AECS and the responses of the leadership team during the March–July 2020 period. The pandemic jeopardised the delivery of eye care to patients in need; challenged organisational sustainability owing to dwindling volumes; and affected the morale of employees, who were afraid of contracting Covid-19. As eye camps were not being organised due to lockdown restrictions, vulnerable patients—economically disadvantaged people and older adults—were at risk of blindness; this risk was exacerbated by the postponement of surgery and fears of contracting Covid-19. Fear turned into panic among doctors, nurses and staff when two nurses at Aravind Eye Hospital Chennai tested positive for Covid-19. To tide over the crisis, Dr S. Aravind, Chief Medical Officer (CMO) of Aravind-Chennai, had to return to the roots of the organisation and reinforce its culture. The Covid-19 pandemic had exposed hidden fault lines in society and shortcomings of the efficiency-oriented business model of AECS. Dr Aravind had to determine ways to reduce the fragility and build resilience in the organisation.