The case describes the remarkable work done in the state of Karnataka, by a hospital in Bangalore, in identifying retinal damages in the incipient stage in premature babies a condition called Retinopathy on Prematurity (ROP). The work is in the pilot stage, covering only Bangalore and three districts around it, but is on the verge of being scaled up to the rest of the State. The case highlights the use of technology, the organization, and the working model of the operation; and raises the issues involved in scaling up as a Public Private Partnership with the Government of Karnataka, and in managing a far flung operation with limited resources.