A cross-sectional study of correlation of climatic droplet keratopathy with dry eye, serum proteins, serum calcium and lipid profile.

Abstract

Background: Climatic Droplet Keratopathy (CDK) is a progressive degenerative condition of the cornea with unclear pathogenesis, though environmental and systemic factors are suspected contributors. This study aimed to explore associations between CDK and dry eye syndrome, serum protein, calcium levels, and lipid profile, to uncover potential systemic and environmental links to disease severity. Methods: A cross-sectional observational study was conducted at a tertiary care center over 18 months, involving 32 CDK patients and 32 matched controls. Participants underwent comprehensive ocular assessments, including Schirmer’s tests and Tear Film Break-Up Time (TBUT), alongside biochemical analyses of serum proteins, calcium, and lipid profile. CDK severity was graded using slit lamp biomicroscopy findings. Statistical analysis was performed using SPSS v22.0. Results: CDK was significantly more prevalent in older males and those with farming occupations. Bilateral involvement was noted in 81.3% of cases. A significant association was found between CDK and abnormal TBUT (95.3% in cases vs. 56.3% in controls, P<0.001) and reduced Schirmer’s II scores (P=0.001), indicating impaired tear film function and basal tear secretion. Serum calcium levels were inversely correlated with CDK severity (P=0.015), while a significantly lower HDL level was observed in cases compared to controls (P<0.001). VLDL levels also varied significantly with CDK grade (P=0.011). However, serum total protein, albumin, A/G ratio, total cholesterol, LDL, and triglyceride levels did not show statistically significant differences. Conclusion: The study highlights significant associations between CDK and tear film instability, reduced basal tear secretion, low HDL, altered VLDL levels, and declining serum calcium with disease progression. These findings support a multifactorial etiology of CDK involving ocular surface dysfunction and systemic metabolic alterations, particularly in rural male populations with high environmental exposure.