The conflict in The Cay is multifold. First, Phillip, the eleven-year-old white boy stranded on the cay, must deal with the task of surviving on the small cay after he is blinded. He must learn to become more independent and navigate his way around the island while blind. Timothy, the Caribbean man who is stranded with Phillip on the cay, teaches the boy skills to become more independent. These skills become even more vital after Timothy dies, leaving Phillip alone until he is rescued.
In addition, Phillip faces the conflict of dealing with his racist feelings towards Timothy. Phillip's mother taught him to regard black people as lesser, and he must overcome these feelings to learn to not only co-exist with Timothy on the island but also to learn to trust him. It is Timothy who cares for Phillip and teaches him how to survive after being blinded, and Phillip comes to recognize Timothy's humanity.