Dry eye, formally known as keratoconjunctivitis sicca (KCS), is a condition where the eyes lack sufficient tears, leading to discomfort and potential vision problems. Tears play a vital role in eye health, providing lubrication, flushing away irritants and infectious agents, and carrying metabolic waste from the outer eye.
Causes of Dry Eye
- Infections: Canine distemper infection and feline herpes upper respiratory infection can both lead to dry eye.
- Congenital Factors: Some animals may have a congenital lack of tear-producing gland tissue, which is observed in certain lines of Yorkshire terriers.
- Medications: Exposure to sulfa-containing antibiotics, such as trimethoprim-sulfa combinations, can lead to temporary or permanent dry eye.
- Injury or Surgery: Damage to tear-producing glands during surgery or trauma to the tear-producing glands can cause dry eye.
- Immune-Mediated: The most common cause of KCS is immune-mediated destruction of the tear-producing glands, particularly in breeds like American Cocker Spaniels, Miniature Schnauzers, and West Highland White Terriers.
Diagnosis
A Schirmer Tear Test is used to measure tear production. A strip of paper is placed in the lower eyelid for 60 seconds, and the moistened area is measured. A length of 15mm or more is normal, while less than 5mm is considered severely dry.
Treatment
- Cyclosporine: Topical cyclosporine eye drops or ointment are the primary treatment for KCS. Cyclosporine suppresses immune destruction of tear glands and restores tear production.
- Tacrolimus: An alternative immune modulator to cyclosporine, used in cases unresponsive to cyclosporine.
- Pilocarpine: For neurogenic KCS, stimulating tear glands, it is given orally.
- Artificial Tear Solutions: Over-the-counter products that can be used along with other therapies to provide relief and soothing.
- Topical Antibiotics: Used to address secondary infections that can occur due to inadequate tears.
- Topical Steroids: May help reduce inflammation associated with KCS.
Surgical Solutions
In severe and unresponsive KCS cases, parotid duct transposition is a surgical procedure where the salivary gland's duct is moved to deliver saliva to the eye as a substitute for tears.
Early diagnosis and appropriate treatment are crucial for managing dry eye and preventing complications such as corneal inflammation and vision impairment.
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