Managing Dry Eye in Dogs

Dry eye or keratoconjunctivitis sicca (KCS) is a relatively common disease of dogs that causes decreased tear production. It is most often an immune disorder in which the components of tears are available, but production is interrupted by the dog’s own immune system, resulting in dry, itchy, crusty eyes. The lacrimal glands (tear producing glands) become inflammed and unable to produce as many tears as the eyes need to keep the cornea lubricated.

PB010062 — Well controlled "dry eye" eyes are indistinguishable from healthy eyes!

Causes of Dry Eye in Dogs:

Immune disorder (most common)
Drug reaction
Removal of gland of the third eyelid to treat “cherry eye” (rarely done anymore, because of the risk of developing dry eye)
Other less common things can cause dry eye as well.

lacrimal – pertaining to tears

kerat/o – cornea (the clear outer covering of the front of the eye)

conjunctiv/a – conjunctiva (the soft tissue surrounding the eye)

itis – inflammation

sicca – dry

Diagnosis:

If your dog has any abnormal eye discharge, squinting, eye redness or other signs of discomfort or abnormalities, see your veterinarian right away! Eye issues are at least as urgent as any other health concern for several reasons…

Eye disease is often uncomfortable (as with dry eye) or outright painful.
Eye issues can progress rapidly.
Eye disease can be a symptom of a larger problem.
Eye diseases can result in blindness – Sometimes this is unavoidable, but sometimes (as is the case with dry eye) the progression of the disease can be slowed or stopped all together and sight can be protected.

Your veterinarian will perform a complete physical exam and one or more eye tests…

A Schirmer tear test is the diagnostic test of dry eye. A thin strip of paper is folded and placed on the cornea. (Yes, that is as annoying as it sounds, but dogs are surprisingly good sports about it!) By measuring the amount of tears wicked up onto the paper in a minute, we can determine whether enough tears are being produced.
A complete eye exam with an ophthalmoscope will probably be done to look for concurrent or related problems.
A fluorescein test may be done to look for corneal ulcers.
Other tests may be needed to diagnose or rule out dry eye and diagnose any concurrent problems.

Treatment:

Before it was known how to regulate tear production, the treatment for dry eye was to surgically transpose the parotid duct (which carries saliva from the parotid gland to the inside of the mouth) from the mouth to an area near the eye, so that saliva would keep the eye moist, comfortable and healthy when tears could not.

How cool/resourceful/creative were vets back in the day?? Not that veterinarians today are not, but before we knew about wonderful, non-invasive immune-modulating eye drops (substitute any of a myriad of present day drugs/procedures/supplies that make medicine simpler today), vets had to do what they had to do.

Treatment of Dry Eye Today:

-Eye drops.

Usually dry eye is treated with daily or twice daily cyclosporine drops or ointment or tacrolimusdrops or ointment. Much less cool/resourceful/creative, except that it is better all around…for the pet, for the family, for the veterinarian who has to say “Drip these drops in the eye,” instead of spending hours on a complex face-rearranging, spit-in-the-eye surgery.

For that reason, as debilitating as dry eye can be if it is not treated (It can cause corneal scarring which can lead to blindness) and as much of a pain as it can be to give eye drops EVERY DAY, dry eye is a much simpler disease than it was even one generation ago.

If you have a dog with eye issues, get him or her to the veterinarian as soon as possible! If you have a dog with dry eye, take heart! Though it is a serious immune disease with potentially debilitating consequences if left untreated, diagnosis is straight-forward, treatment is simple and the prognosis is excellent.