Climatic droplet keratopathy CDK is an acquired and potentially handicapping cornea degenerative disease that is highly prevalent in certain rural communities around the world. It predominantly affects males over their forties. It has many other names such as Bietti's band-shaped nodular dystrophy, Labrador keratopathy, spheroidal degeneration, chronic actinic keratopathy, oil droplet degeneration, elastoid degeneration and keratinoid corneal degeneration. CDK is characterized by the haziness and opalescence of the cornea's most anterior layers which go through three stages with increasing severity. Globular deposits of different sizes may be histopathologically observed under the corneal epithelium by means of light and electron microscopy.
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Labrador keratopathy and Bietti's nodular dystrophy are acquired corneal degenerations affecting men who have spent their working lives outdoors; they are thought to be caused by climatic exposure.
This report shows that such corneal disease occurs more frequently than has been suspected and suggests ultraviolet irradiation as a common etiogenic factor. Since the clinical appearances and pathologic changes in all cases are similar, differing only in degree of severity, it is suggested that these diseases be considered a single entity called climatic droplet keratopathy.
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Climatic Droplet Keratopathy: An Old Disease in New Clothes
The source of the proteinaceous material forming the droplets is not well understood. Proposed theories include the diffusion of serum proteins from the limbal vessels to the cornea as a result of interactions with ultraviolet light. Increasing age and exposure to ultraviolet light are the most common associated risk factors. Other factors include dry eyes, malnutrition, corneal trauma or microtrauma from wind, sand or ice, low humidity, and extreme temperatures.
Climatic Droplet Keratopathy
Climatic droplet keratopathy CDK is a degenerative condition characterized by the accumulation of translucent material in the superficial corneal stroma within the interpalpebral strip, beginning peripherally and spreading centrally. Progressive accumulation in later life can lead to significant visual disability, and people leading an outdoor life are particularly at risk. The translucent corneal deposits are composed of protein, but although they share some of the staining characteristics of degenerated protein, such as that found in pingueculae, their exact histochemical nature remains uncertain. The corneal deposits are thought to be derived from plasma proteins, which diffuse into the normal cornea, and may be photochemically degraded by excessive exposure to ultra-violet light UV. The degraded protein material may then be deposited in the superficial stroma. UV light is now widely accepted to be the main etiological factor in the pathogenesis of CDK.