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Keratoconjunctivitis sicca (‘Dry Eye’)
‘Dry eye’ is a common eye disease of dogs. It occurs when insufficient tears (which are essential to keep the eye moist and healthy) are produced from the tear glands and is diagnosed by measuring tear production using a ‘Schirmer Tear Test’.
The main aims of treatment are to keep the eyes comfortable, free from infection and to preserve vision by increasing tear production or by giving artificial tears. Most cases of dry eye will need lifelong management. Treatments will vary from case to case and depending on the suspected cause of the ‘dry eye’. However, treatment options usually include the following:
Medication to stimulate tear production. In most cases, the first-line treatment is cyclosporine eye ointment (Optimmune TM ). Optimmune treats the underlying cause of dry eye (destruction of the tear glands by the body's immune system) and as such is the best treatment in mild to moderate cases. It is usually very effective, but it needs to be given twice daily every day, and lifelong treatment is usually required. If Optimmune is ineffective, we will sometimes prescribe a stronger solution of cyclosporine (cyclosporine in corn oil). Alternatively, a different eye drop called tacrolimus may be effective. .
Artificial tears. These include drops, gels and ointments to keep the surface of the eye moist and prevent evaporation of tears. These do not treat the underlying cause, but instead help to replace the tears that are not being produced.
Antibiotics. Corneal ulcers and bacterial infections occur quite commonly in dogs with ‘dry eye’ and so antibiotic eye drops may be prescribed from time to time.
Surgery. Surgery (Parotid Duct Transposition, PDT) can be performed should the above medication prove unsuccessful. The surgery involves moving a salivary duct from its usual opening into the mouth to inside the lower eyelid. Saliva is then secreted onto the surface of the eye and acts to 'mimic' tears and keep the surface of the eye moist. Note that even after surgery, lifelong management may still be needed to keep the face clean and treat any complications that can occasionally be caused by saliva being present in the eye instead of tears.
Whatever treatment is advised, management will usually be needed for the duration of the dog’s life and regular visits to the ophthalmologist or your own vet will still be needed. During these visits, the health of the eye will be checked, tear production will be reassessed and any side effects of the treatment strategies will be monitored.