Retinopathy of prematurity (ROP) remains an important cause of avoidable childhood blindness. Treatment is effective, but the window for intervention is relatively narrow during infancy. At-risk infants must be identified, examined at the appropriate postmenstrual age, and followed until retinal vascularization is complete. In many low- and middle-income countries, improved neonatal survival has not been accompanied by comparable access to blended oxygen, continuous oxygen-saturation monitoring, trained ROP examiners, or treatment. This mismatch has contributed to the “third epidemic” of ROP.