Buzzards Bay Veterinary Associates

BBVA Buzzards Bay Veterinary Associates

230 Main Street * Buzzards Bay, MA 02532 * Tel: 508-759-2521 * Fax: 508-759-6782

Dry Eye or KCS

(keratoconjunctivitis sica)

KCS is painful but treatable.

What is KCS?

Keratoconjunctivitis sicca is a progressive inflammatory condition of the cornea and conjunctiva that in most cases occurs because the body attacks the cells that make tears. A normal tear film contains secretions from a few types of cells, some cells make the watery portion of tears and other cells make the mucous portion of tears. When the cells that make the watery part of the tear film no longer work, the mucous producing cells make large amounts of greenish yellow mucous in a compensatory attempt to keep the eye moist. The result is decreased production of tears, increased production of mucous, inflammation, pain, and increased susceptibility to a scratched cornea and possibly blindness. KCS is painful to your pet and is treatable!

Does my pet have dry eye?

Bulldogs, West Highland White Terriers, Lhasa Apso, Chinese Pug, American Cocker Spaniel, Pekingnase, Yorkshire Terrier, Shih Tzu, Miniature Schnauzer, Boston Terrier, Dachshund, Chihuahua, German Shepherd dog, and Doberman Pinschers are commonly affected with KCS or dry eye. The incidence of KCS increases with age in all breeds. Exophthalmic breeds (bug-eyed dogs like pugs and bulldogs) are more predisposed to this disease even if tear production is within normal ranges.

What are the signs of dry eye?

In the early stages of the disease, dry eye may be associated with red eyes (conjunctivitis), pain and discomfort. The affected animal will usually blink and squint excessively especially on bright sunny days. In animals with chronic disease, pain and excessive blinking may not be observed. Thick mucus- like discharge (yellow-green in color) may also be observed. In more severe cases, painful corneal ulcers (which feels like a piece of glass is stuck in your eye), edema (fluid accumulation) and pigmentation (dark coloring of the cornea) will be noted. In cats, signs are more subtle and they may have a similar manifestation as chronic conjunctivitis caused by a viral infections.

What causes KCS?

There is strong evidence indicating that most cases of KCS that affect both eyes are caused by an abnormal response of the body's immune system against tear producing glands. The body actually attacks itself. In some cases, drugs (sulfa drugs, etodolac) and diseases such as distemper have been associated with KCS. Cancer therapy such as radiation can lead to dry eye syndrome as well.

How is KCS diagnosed?

The presence of clinical signs and a evidence of low tear production measured by a Schirmer Tear test (STT) confirm a diagnosis of dry eye. A Schirmer Tear Test (STT) is done by inserting a small piece of sterile paper under your pet's lower eyelid. After one minute the strip will show a reading. Any pet with a reading of < 10 mm/minute is considered to have KCS.

KCS therapy:

Cyclosporin A ointment (Optimmune®) or compounded cyclosporine suspension will be prescribed once to twice per day depending on the severity of the case. This medication acts to stop the body’s attack on its own cells which produce tears. The result is a return to the production of tears in some cases. Artificial tears in either ointment or drops can be used for the treatment of mild cases of KCS or in conjunction with Cyclosporine. In some animals, the condition will not respond to cyclosporine therapy. These cases are usually those in which all of the cells which produce tears have died – normally this is in animals who have had untreated KCS for a long time. Surgery (transplanting a salivary gland duct into the affected eye), is sometimes indicated, but has been less common since the advent of Cyclosporine. Chronic cases of KCS result in increased pigment in the cornea. This is similar to the effect of wearing very dark sunglasses. If tear production can be restored for these patients, they may be candidates for a superficial keratectomy. We recommend a board certified veterinary ophthalmologist perform this type of procedure and can refer you to such a specialist if your pet is a good candidate.

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