Dry Eye: What You Need To Know

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Keratoconjunctivitis Sicca (KCS), also known as dry eye, is a condition where dogs do not produce enough tears to moisten and lubricate the surface of the eye. This usually happens because a dog’s immune system becomes confused and starts to attack the gland in the eye that produces the tears. As the gland is gradually destroyed, fewer tears are made, and eventually there may be none at all. Sometimes this will only affect one eye, but often progresses on to involve both eyes.

If tear levels in the eye are low, they will become dry and sore. From the outside, this initially makes the eyes look red and inflammed, and the surface may look drier than normal. With time, the eyes will produce a sticky green discharge that can be seen over the surface and may accumulate around the edge of the eye, giving it an unpleasant “gunky” appearance. The eyes become very sore and may take on a blueish tinge as the surface becomes inflamed. In severe cases, the surface of the eye may become eroded and a corneal ulcer form (see later).

There are several different ways to treat dry eye. The treatment choice depends on how severely the eyes are affected, and how your dog responds to the different treatments. Treatment is usually life-long. Your vet will advise you on which treatments may be appropriate for your dog.

Artificial tears
Artificial tears are drops that are made to mimic natural tears. However, these drops are not as good at lubricating the eye as natural tears, and need to be applied very frequently during the day (at least 6-8 times a day, often more) to be effective.

For mild cases of dry eye, sometimes the eye can be made comfortable by simply supplementing the low tear levels with artificial tears. However, this does not stop the destruction of the tear glands and the disease often worsens with time.   More often, these drops are used alongside other medications to keep the eyes comfortable.

Ciclosporin drops (Optimmune®)
Optimmune ® is the most common treatment we use for dry eye, often alongside artificial tears. Ciclosporin is a drug that suppresses the immune system, so applying it to the eyes can stop your dog’s body from destroying the tear glands. This allows natural tear production to resume.

Optimmune usually works within week, but occasionally may take up to 6 weeks to be fully effective. Often, artificial tears are used initially alongside this treatment, to make you dog’s eyes comfortable.

Other drops
If Optimmune is not successful at controlling you dog’s symptoms, occasionally we may use other drops to suppress the immune system within the eye, such as tacrolimus. However, these drops can be difficult to get hold of, and we may recommend that you see a specialist veterinary ophthalmologist if these they are needed.

Surgery
In some cases, we cannot restore tear production with medication, or some dogs will not allow us to administer eye drops. In these cases, there are some surgical options available to provide moisture to the eye. However, the results are not as good as with medication, and there can be longer-term side-effects. If you would like more information, please speak to your vet.

Applying eye drops
Dogs with dry eye will normally be on lifelong eyedrops, so it is important that you get used to applying them. It is normally easier to approach your dog’s eye with the dropper from the side or back (rather than the front) as they will shy away less. Sometimes it is helpful to have two people initially, so that one person can hold the dog and the other apply the drops. If you are still having difficulties after a few days, do get back in touch and we can arrange a session with a vet or nurse to see if we can help.

It is also a important to make the experience a positive one for your dog. Giving them a small treat after applying drops can be helpful, as it may encourage them to look forward to the experience rather than dreading it.

If your dog is on multiple eye drops, then you should leave at least an hour between applying different drops to prevent one drop being washed out of the eye by a second.

Bathing the eyes
Dogs with dry eye often have sticky discharge from their eyes. It is important to prevent this discharge from building up, as this can lead to crusting that is very irritating and causes dogs to rub and scratch their eyes, which may cause further damage to their eyes. This is best done with cotton wool, dipped in boiled water that is allowed to cool. Again, a treat after cleaning may help your dog to tolerate this better!

Dogs with dry eye are more prone to developing infections in their eyes. Signs that your dog may have an infection include increased redness or swelling in or around the eye, an increase or change in the discharge coming from the eye, or a sudden increase in discomfort in the eye. If you see any signs of this, please contact your vet. We do not recommend using “left-over” medication from any previous infections; it may be ineffective and your dog needs to be examine by a vet to confirm infection, rather than anything more serious, is the cause of the changes.

A corneal ulcer is a serious condition where the surface of the eye (the cornea) has been damaged. This can happen with trauma, infection, or with untreated or poorly managed dry eyes. The surface of the eye does not have its own blood supply, so these ulcers are slow to heal, as often the blood supply must “grow in” from the outside. In more serious cases, the ulcer may continue to deepen and eventually cause the eye to rupture. If this happens, generally the eye cannot be repaired, and must be removed instead.

Corneal ulcers are sometimes visible to the naked eye, and appear as an indentation or cut into the clear surface of the eye. They may be surrounded by a white-blue cloudiness. However, some ulcers are not visible without a dye being applied to the eye, which is why regular examinations with a vet are important. If you suspect your dog may have a corneal ulcer, this is an emergency, as untreated ulcers can cause the eye to rupture. Contact your vet immediately.

If you’re concerned your dog may have dry eye, or if they’ve already been diagnosed and you need guidance, we’re here to help. Contact your nearest practice today to speak with our caring veterinary team and ensure your dog gets the support they need.

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