Keratoconjunctivitis Sicca (KCS) or Dry Eye
Overview
Keratoconjunctivitis sicca (KCS) is a syndrome that occurs in response to a deficiency of tear production in the eye. This is extremely common in dogs and cocker spaniels, bulldogs, Lhasa apsos, and shih tzus are predisposed.
Causes
The most common cause of KCS is immune-mediated disease, meaning the patient’s own body disrupts the tear production. These patients generally also have immune-mediated disease elsewhere such as atopy. There may be a genetic trait, but that has not been confirmed. Sulfa antibiotics (TMPZ, Albon) and etodolac can cause KCS. If a patient had the lacrimal gland removed as a treatment of cherry eye, they will likely develop KCS.
Symptoms
The initial signs of KCS can mimic viral or bacterial conjunctivitis: squinting, reddened conjunctiva, prolapsed third eyelid. As the disease progresses, the cornea will swell, become discolored, and may develop ulcers. There is usually abundant discharge and crusting around the eyes. If left untreated, the patient will lose their sight.
Treatment
KCS is a chronic condition and will require medication for life. Cyclosporine ointment is the treatment of choice and is initially used twice daily. If the patient is doing well after several months, the medication can be tapered to once daily. However, most pets will need the ointment twice daily. If the patient has been diagnosed with KCS in only one eye, the other eye will likely develop clinical signs in the future.
