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Dry Eye / Keratoconjunctivitis sicca (KCS)
What Is “Dry Eye”?
“Dry eye syndrome", (otherwise known as KCS: keratoconjunctivitis sicca) often results from a lack of tear production. The cause of dry eye is usually unknown but some known causes include: congenital disorders (puppies), infections (canine distemper virus), drug–induced (sulfa antibiotics, Etogesic), and removal of the tear gland of the third eyelid ("cherry eye"). The disease is seen very commonly in certain breeds such as the Cocker Spaniel, Shih Tzu, Lhasa Apso, Bulldog, Schnauzer, and West Highland White Terrier.
What Are The Symptoms Of KCS?
The clinical signs of dry eye include: heavy mucus production, redness, rubbing at eyes, cloudy eyes, corneal ulcers, and even general lethargy. After an extended period of dryness, the surface of the eye (cornea) begins to accumulate dark scar tissue and blood vessels – to the point of blindness in many patients! This situation is similar to having a complete layer of mud on your glasses.
How is KCS Treated?
Our treatment goals for dry eye include stimulation of tears, lubrication, and decreasing the scar tissue. There has been a major breakthrough in the treatment of this disease with the development of the drugs Cyclosporine and Tacrolimus, both anti-rejection drugs used in organ transplant surgeries. These drugs are about 75% effective in stimulating new tears in the dog. Both have to be used absolutely as directed. If you skip a dose or run out of the medication, then dry eye signs will immediately recur. In addition, it is crucial that you have your dog checked as directed to monitor treatment success. Some patients respond better to one than the other. The Tacrolimus is slightly stronger than the cyclosporine, so dogs that no longer respond to the first drug may show improvement if treated with the second. Ocular lubrication is best provided by the more viscous artificial tear preparation such as GenTeal gel drops, Refresh Liquigel drops, Thera Tears liquid gel drops, or Celluvisc drops. If the tear stimulation treatment improves the tear production rate, then the lubrication drops can be used less often.
What Happens If the Medication Doesn’t Work?
In some dogs, the tear production does not improve and, other than frequent application of the artificial tear preparations, the only other procedure that provides moisture to the eye is to perform a salivary duct transposition surgery to reroute saliva to the eye surface. This is called a parotid duct transposition.
Please feel free to ask further questions about cataracts to our outstanding support staff.
Steven M. Roberts, DVM, MS, DACVO
Holly L. Hamilton, DVM, MS, DACVO
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