Objectives/Goals: Infectious keratitis is the leading cause of corneal blindness worldwide, causing two million cases of monocular blindness per year. Of these cases, developing countries are disproportionately affected, in part due to sociodemographic disparities. Our study examined risk factors for severe keratitis presentation in a South Indian population. Methods/Study Population: 156 patients aged ≥ 16 years with clinically diagnosed infectious keratitis presenting to Aravind Eye Hospital in Pondicherry, India, from January 1, 2023 to July 31, 2024, were retrospectively reviewed. Univariate logistic regression was used to evaluate associations between specific potential risk factors (including age, sex, awareness of keratitis, travel distance to hospital, education level, missed work wages, and ability to afford care) and keratitis clinical severity (defined using thresholds of poor visual acuity, size of stromal infiltrate measured on slit lamp examination, occurrence of perforation, and need for corneal transplant surgery). Individual risk factors found to be significant were incorporated into a multivariable logistic regression model. Results/Anticipated Results: We anticipate that the results of this study will identify multiple risk factors for more severe keratitis presentations among patients at baseline. We expect these factors to include increased travel distance from the patient’s home to the base hospital, delays between time of diagnosis and initiation of treatment, treatment nonadherence, lower educational levels, lack of familiarity with keratitis, treatment and transportation costs, increased time off work, and missed work wages, among others. Discussion/Significance of Impact: This study elucidates barriers to early keratitis diagnosis in a low-resource setting. Study findings can inform strategies to improve keratitis prevention using decentralized care approaches such as community eye screenings and expanding outreach via vision centers. Such strategies can improve timely access to care for vulnerable populations.