Climatic Droplet Keratopathy : Case Report

The purpose of this case report is to highlight an uncommon presentation of Climatic Droplet Keratopathy (CDK) in a 70-year-old female, emphasizing its clinical features, potential causes, and risk factors. It aims to raise awareness about early detection and preventive measures, particularly UV protection, to avoid long-term visual impairment. Additionally, it discusses treatment options for severe cases, including keratoplasty and keratectomy

Climatic droplet keratopathy  is a corneal degenerative disease that can be acquired and  cause disability. It is quite common in some rural populations worldwide. Males in their forties are primarily affected.

Also known as  Bietti's band-shaped nodular dystrophy and  Labrador keratopathy, it is related to principle risk factors as increasing age and exposure to ultraviolet light

Other factors include dry eyes,  corneal trauma, or microtrauma from wind, sand or ice, and extreme temperatures. 

70-year-old female patient, with no history, who presents a decreased  visual acuity with the appearance of yellowish deposits on the cornea of the right eye

The ophthalmological examination on admission reveals positive light perception  in the right eye

At the slit lamp : homogenous, transparent, thin, golden yellow globules of different sizes  from the limbus to the  center of the cornea that are seen in the epthelium ; subepithelium, and  superficial corneal stroma

At the fundus : inaccessible due to corneal haze associated

Ocular tonus =16 mmHg.

It's unclear where the proteinaceous substance that forms the droplets comes from.However some reserches proved that plasma proteins, including albumins and maybe immunoglobulins, may accumulate in the cornea from the limbal circulation and be altered by UV light.

 Additionally, the deposits may have been secretory products of the stroma and/or epithelium, which comprise damaged stromal collagen or incomplete collagen.  The onset and progression of spheroidal degeneration have been linked to environmental physical irritation of the corneal surface, including sand, UV radiation, wind, and welding burns. 

Most individuals do not need therapy, and the prognosis is typically favorable. 

Although the disease is slow in progression, significant visual compromise is a long-term consequence in untreated patients .

In this cases , lamellar keratoplasty, phototherapeutic keratectomy, superficial keratectomy, and in the worst situations, penetrating keratoplasty are possible treatments.