A cay (also spelled key, but both are pronounced alike as "key"
Sand cays are formed when tidal action, wind and sea birds deposit, over a long period of time, coral debris and sand onto reef flats, usually on the leeward side of the reef, but occasionally on the windward side. weather affects the formation of cays greatly; large tides would bring much more debris onto the cay and thus make it larger, while a hurricane could completely obliterate a cay.
An example of a coral cay is Heron Island.