VISION 2020 has made significant strides in blindness prevention efforts. However despite the combined efforts of civil society, governments and professional associations, many of the targets set are appearing increasingly elusive. Therefore in the next ten years the challenge for IAPB and partners is to significantly upscale efforts. Merely increasing the current strategies will not create the critical mass that is needed to catapult eye care services to the next level. New innovative and creative approaches need to be explored.