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Introduction Systemic Sclerosis (SSc) is an autoimmune disease comprising of autoimmune activation, inflammation leading to vasculopathy and fibrosis resulting in organ damage. It is very heterogenous in its pattern and extent of clinical manifestations.To date, very little is known about eye manifestations. We present such a case.Material and Methods A 44-year lady with mild stable limited cutaneous systemic sclerosis diagnosed in 2022 upon reviews over time showed only mild progression at last review in August 2024. Her clinical features and laboratory test details are as in table 1a and 1b. She also had baseline PFTs, ECHO and CXR (which were all normal). Her medications were omeprazole only. Calcium channel blocker had been advised but her preference was for physical therapy for her infrequent raynauds.In February 2025 she developed sudden blurring of vision in her left eye.Results She was seen promptly in the Eye clinic and was diagnosed with left eye central retinal vein occlusion (CRVO). The results of her examinations before and after the therapy are as in figure 1 & 2.Conclusions Eye manifestations, the appropriate guidelines for screening and their treatment of SSc remains an unmet need.Literature review by K. Paczwa et al have illustrated the various ocular manifestations of SSc in their review based on case reports or short small studies only.Our patient is a very young lady with stable lcSSc with minimal mRSS score, as well as had infrequent raynauds, nevertheless still developed CRVO with its inherent morbidity of diminished vision. She received Bevacizumab (an anti-angiogenic agent; an anti-VEGF-A agent) with which she apparently seems to have stabilized temporarily. However, there is scant data on the role of calcium channel blockers, immunosuppressive agents (ISA), endothelin receptor blockers, or even on anti-fibrotic agents in prevention or treatment of retinal complication secondary to SSc, which remains an unmet need.We would suggest further larger studies are needed to see if there is any significant association, as well as any role of various agents currently used in SSc with vasculopathy or fibrosis as well as to confirm the findings of fewer smaller studies done earlier having shown possibility of association with the NVC, mRSS and disease activity. We also, wonder if there ought to be screening guidelines in SSc patients regarding eye involvement?Abstract P.362 Table 1Abstract P.362 Figure 1Fundoscopy of right & left eyeAbstract P.362 Figure 2OCT Scan left eye before and after Avastin Injection