Dry Eye in Dogs: Common Causes and Treatment Options

Have you ever gotten an eyelash or hair stuck in your eye? That feeling of constant irritation is similar to what dogs with dry eye experience. Dry eye in dogs is a chronic condition that can lead to corneal scarring or damage, interfering with vision and comfort. However, if pet owners know how to recognize symptoms of dry eye, most dogs respond well to simple treatments.

What Is Dry Eye in Dogs?

Dry eye in dogs, also known as keratoconjunctivitis sicca (KCS), is a condition where the eyes don’t produce enough tears to lubricate and nourish the corneas. Tears play a vital role in keeping the surface of the eye clean, comfortable and protected.

The tear film consists of three layers: a mucin (mucous) layer, an aqueous (watery) layer and a lipid (oily) layer. Typical dry eye leads to reduced aqueous secretion, resulting in thick, mucousy tears. This often causes the eyes to become dry, irritated and red. If the condition goes untreated, the corneas can develop inflammation or scarring and become more vulnerable to injuries that can quickly become serious.

Dry eye in dogs is a common and treatable condition. With a prompt diagnosis and a consistent care routine, most dogs with KCS live normal, healthy lives and maintain functional vision.

Types

Dry eye can present in several ways, each requiring slightly different treatments:

• Aqueous tear deficiency. This is the most common type of KCS, which develops when a dog’s tear glands don’t produce enough of the watery tear component.
• Neurogenic dry eye. Occasionally, dry eye is caused by nerve damage, often from chronic ear infections, rare reactions to certain medications or other nerve conditions affecting the face.
• Qualitative tear film deficiency. Qualitative KCS is a lack of the oily tear film layer, which prevents tears from evaporating too quickly. This form is usually mild, but can be challenging to diagnose.

Potential complications

Dry eye in dogs can lead to more serious issues:

• Corneal scarring. Some dogs develop brown pigmentation on their corneas in response to long-standing inflammation. This pigmentation can partially or completely obstruct vision.
• Corneal ulcers. Dry eye leaves the surface of the eye more vulnerable to injuries such as scratches or ulcers. If these wounds become infected or deepen, as they can do quickly, they can lead to eye loss.
• Eye rupture. Severe ulcers can extend through the full thickness of the cornea, causing a hole that can allow fluid to leak out and lead to the dislocation of structures inside the eye. A ruptured eye may heal with time or grafting surgery, but may also require surgical removal.

Common Causes of Dry Eye in Dogs

Dry eye has several possible causes, and certain factors can increase a dog’s likelihood of developing the disease. The most likely causes include:

• Autoimmune dysfunction. The most common cause of dry eye in dogs, this causes the immune system to attack tear gland cells, rendering them unable to produce tears.
• Cherry eye. Cherry eye occurs when the third eyelid gland, which produces a portion of the eye’s tears, prolapses out of its normal position. The gland can become inflamed and damaged, decreasing tear production and leading to dry eye. Removing the gland surgically will cause dry eye in 30% to 40% of affected dogs, whereas replacing it surgically — the preferred treatment — reduces the incidence of future dry eye to around 20%.¹
• Congenital disorders. Dogs can be born with missing or malformed tear glands, usually in only one eye. In this case, dry eye develops early in life.
• Medications. Sulfa-based antibiotics and certain anesthesia drugs can temporarily or permanently reduce tear production. 
• Nerve damage. Damage to nerves in the face and head can interfere with tear gland stimulation. Diabetic pets may be more likely to develop nerve problems that lead to KCS.

Contributing factors

The following factors don’t cause dry eye, but they can make it more likely that your dog will develop the problem:

• Aging. Similar to people, tear production in dogs can decline with age.
• Facial structure. Brachycephalic breeds (i.e., dog breeds with short noses and large eyes, such as pugs and shih tzus) tend to have more eye problems than dogs with longer noses.
• Injury or trauma. Damage, inflammation or scarring from trauma that affects the tear glands or nearby tissues may contribute to KCS development.

Breeds prone to dry eye

Some dog breeds are more likely to develop dry eye than others, suggesting that genetics may play a role. Predisposed breeds include:²

• Bulldog
• Cavalier King Charles spaniel
• Cocker spaniel
• Lhasa apso
• Pug
• Shih tzu
• West Highland white terrier

Symptoms of Dry Eye in Dogs

Dry eye that develops gradually may seem like simple irritation or allergies. But over time, dogs with KCS develop visible changes and discomfort. 

Common symptoms of dry eye in dogs include:

• Color changes. The whites of the eyes may become irritated and red, while the cornea may look dull, white, blue, cloudy or brown.
• Rubbing. Your dog may rub their eyes with their paws or against furniture to relieve itching and discomfort.
• Squinting. Dogs may blink frequently or hold their eyes partially closed.
• Thick ocular discharge. Dogs with KCS often develop a thick yellow or green discharge that accumulates shortly after cleaning.

These signs can also occur with other eye problems, so a visit to your veterinarian can be the best next step if you notice anything unusual.

Diagnosing Dry Eye in Dogs

Your family veterinarian can diagnose dry eye and prescribe treatments. In some cases, they may refer you to a veterinary ophthalmologist for long-term management. 

During an eye exam for suspected dry eye, your vet will measure your dog’s tear production and check for scratches or scars using these tests:

• Eye exam. Your veterinarian will use an ophthalmoscope to examine your dog’s eyes for signs of disease. They will also check their reflexes and basic nerve function around the eyes. You can expect a more detailed eye exam if you visit a veterinary ophthalmologist for care.
• Fluorescein stain. A temporary dye that highlights injured areas of the cornea is applied to your dog’s eyes. 
• Schirmer tear test (STT). An STT uses a soft paper strip placed inside the lower eyelid to measure how quickly tears wick up the strip over a one-minute period. 

These tests take only a few minutes and can provide valuable information. The sooner dry eye is diagnosed, the easier it is to manage and prevent long-term problems.

Treatments for Dry Eye in Dogs

Most cases of dry eye respond quickly to simple treatments, such as daily eye drops. Treatment for uncommon causes of dry eye, such as nerve dysfunction, can be more intensive. In rare cases, dogs with dry eye might need surgery.

Medical treatment

Topical eye drops and ointments are the first-line treatment for dry eye in dogs. You may need to apply them up to three times daily, especially at first, and adjust the frequency based on your dog’s response. Medications may often include:

• Anti-inflammatories. Anti-inflammatory eye drops, often given in combination with an antibiotic, can help prevent or treat inflammation and scarring caused by dry eye.
• Antibiotics. A short course of antibiotics may be needed to prevent or treat an eye infection, especially if your dog develops a corneal ulcer. Antibiotics can also help relieve symptoms by changing the eye’s bacterial balance (i.e., microbiome).
• Artificial tears. Lubricating gels, ointments and drops can provide temporary comfort and protection to dry eyes, but they don’t treat the underlying problem.
• Immune modulators. Tacrolimus and cyclosporine are often used to control local inflammation, helping the glands to produce more tears.  

If these treatments aren’t successful, a veterinary ophthalmologist may recommend higher medication doses, nerve-stimulating medications or anti-inflammatory implants.

Medical treatment for dry eye is lifelong, as the medications help manage the condition rather than cure it. However, many pet parents find they can reduce the medication frequency once symptoms are under control. 

Surgical treatment

For severe dry eye cases that don’t respond to medications, a veterinary ophthalmologist may recommend a parotid duct transposition surgery. This procedure moves a salivary duct from the mouth to the eye, allowing saliva to help moisten the eye surface. The surgery is invasive and not every dog is a good candidate, but it can offer relief for some.

The Cost of Dry Eye Treatment for Your Dog

Dry eye is a lifelong condition, which means that it involves recurring costs for ongoing eye medications, eye exams and any complications that might arise from KCS. Costs can vary depending on your dog’s condition, where you live and the exact treatments your pup needs.

The following table outlines the national average costs* you may encounter for dry eye diagnosis and care.³

Preventing Dry Eyes in Your Dog

Unfortunately, there’s not much that pet owners can do to prevent dry eye from developing. However, you can avoid complications by promptly identifying and addressing dry eye symptoms when they arise. 

If your dog has cherry eye, chronic ear infections or diabetes — less common causes of KCS in dogs — talk to your veterinarian to develop a comprehensive treatment plan that will address the underlying issue and reduce the likelihood of dry eye development. 

A Bright Outlook for Dogs With Dry Eye

Dry eye in dogs may seem like a serious diagnosis, but early detection and ongoing treatment can help preserve vision and comfort in most affected dogs. For many dogs and their families, managing the condition becomes part of their daily routine. Working closely with your veterinarian and alerting them to any changes in your dog’s eyes can help protect your dog’s eye health and keep them feeling their best.

Frequently Asked Questions About Dry Eye in Dogs

If you still have questions about dry eye in dogs, here are answers to some commonly asked questions by pet owners.

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Author Bio

Angela Beal, D.V.M., has more than 20 years of experience as a veterinarian. Leveraging her background in private practice and academia, she uses her passion for writing to convey information to pet owners to help them keep their pets healthy and happy.