FP650

Title: Upside down! 

Purpose: To report an atypical case of Terrien’s corneal degeneration
Materials/methods: A 44 year old male with diminution of vision & redness in Right Eye in 2016. He had Best Corrected Visual Acuity (BCVA) of 6/18, anterior segment examination revealed inferior vascularization and peripheral thinning with lipid deposition. A clinical diagnosis of atypical Inferior Terrien’s degeneration was made. Blood investigations (ESR, CRP, ANCA profile) were done to rule out systemic vasculitis which was negative. Scleral contact lens (SCL) trial was done which improved BCVA to 6/9. Inferior pseudo-bleb was formed by aqueous leaking through breach in Descement’s membrane leading to intralamellar accumulation of aqueous for which lamellar patch graft was performed in 2021.Currently patient is doing well with BCVA of 6/12p(SCL).  
Conclusion/results: While Terrien’s is known to occur superiorly, we aim to highlight the possibility of it occurring in the inferior cornea as well.