The evolution of ophthalmology in Indonesia reflects substantial clinical progress achieved within a complex and demanding service environment. Across this vast archipelago, diagnostic and therapeutic technologies—including microsurgery, imaging, laser therapy, and pharmacotherapy—have been introduced and widely adopted. Yet these advances have not translated into equitable population benefit. Geographic isolation, the maldistribution of human and financial resources, and fragmented referral pathways continue to restrict access to timely, effective, and high-quality eye care, particularly in underserved communities. The central question is therefore no longer whether Indonesia can acquire modern ophthalmic capabilities, but whether these capabilities can be organised systematically into an accessible, equitable, and accountable national eye-care system. In 2022, the World Health Organization (WHO) launched its framework for integrated people-centred eye care (IPEC), which places the needs of individuals and communities at the centre of service delivery and promotes a coordinated continuum encompassing health promotion, prevention, diagnosis, treatment, disease management, and rehabilitation across all levels of the health system. Viewed through this lens, the evolution of ophthalmology in Indonesia should be assessed not solely by the adoption of modern technologies and procedures, but by the extent to which it serves a broader public purpose: from hospital-centred treatment to population-centred prevention and integrated care; from episodic charitable outreach to sustainable and equitable coverage; and from expertise concentrated in major cities to connected service networks across provinces. This Perspective traces major milestones in Indonesian ophthalmology, identifies persistent gaps, and proposes priorities for translating clinical and technological progress into equitable and effective population eye care.