The Dry Eye Zone

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Abstract: Canine neurogenic KCS

Most of us aren't here to talk about canine dry eye but every now and then something comes up in the veterinary literature that looks interesting in some way. I was just intrigued to see this "neurogenic KCS" diagnosis, which is not something I come across in hearing of humand dry eye diagnosis. In fact other than extremes (like a cornea with severely reduced sensitivity) and Perry Rosenthal's work I don't hear much about the nervous system and dry eye. Nor was this abstract particularly enlightening but I thought I'd post it. Googling on the topic brought up a rather good overview by a veterinarian.

Canine neurogenic Keratoconjunctivitis sicca: 11 cases (2006-2010).

Objective 
To describe the clinical data of dogs with neurogenic Keratoconjunctivitis sicca (KCS) and an ipsilateral dry nose without other neurologic deficits.

Procedure 
The retrospective case study included 11 dogs diagnosed with neurogenic KCS and an ipsilateral dry nose between 2006 and 2010. Medical records were reviewed for breed, age, sex, history, suspected cause of neurogenic KCS, clinical signs, and treatment modalities. Follow-up information was obtained by re-examination of patients or completion of a telephone survey with the referring veterinarian or the owners.

Results 
Mean age of the dogs was 6.6 ± 4.5 years. Neurogenic KCS was diagnosed in three females, five spayed females, one male, and two castrated males representing 10 different breeds. Ophthalmic signs of KCS (mean Schirmer tear test [STT] value of 1.9 ± 2.9 mm/min) combined with an ipsilateral dry nose were diagnosed in seven left and four right eyes. The suspected cause of neurogenic KCS was idiopathic in nine and trauma in two cases. Systemic therapy consisted of oral pilocarpine 1-2% eye drops combined with case-specific topical treatment with cyclosporine 0.2% and tear substitutes. Duration of systemic treatment with pilocarpine until healing was 125 days (range 84-204, median 98 days) for five dogs. One dog was lost to follow-up, and the remaining five dogs are still under systemic treatment with pilocarpine.

Conclusions 
Neurogenic KCS with an ipsilateral dry nose seems to be a predominantly idiopathic disease of middle-aged female dogs without breed predisposition, which may be self-limiting in some cases.


Vet Ophthalmol. 2011 Oct 31. doi: 10.1111/j.1463-5224.2011.00968.x. [Epub ahead of print]
Matheis FL, Walser-Reinhardt L, Spiess BM.
Equine Department, Section of Ophthalmology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, CH-8057 Zurich, Switzerland.
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