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7-Year Old Maltese Dry Eye Discovered

July 7, 2010

Dogs Get “Dry Eye,” Too!

Harry was a seven-yer-old male intact Maltese (little white fluffy dog) with an excellent groomer and conscientious, detail-oriented parents.  If they said his eyes had too much goop, then the eyes were too gooey.

“Doc, we clean Harry’s eyes every morning, sometimes in the evening, too.  And they still have this discharge!” said Harry’s mom.

“Is the goo yellow, green, or grey?” asked Doc Truli.


“What color is the goo?” repeated Doc.

“Oh, it’s a grey-white color, sort-of,” said mom. “What does that mean?”

“Yellow or green usually means an active eye infection.  Grey or greyish, clearish goo is better because there’s probably not a complicating infection,” said Doc Truli.

“What causes that?” asked mom. See, you’re not the only one who wonders…

“Let’s do a few eye tests and we’ll see,” said Doc.

Eye Tests

The intraocular pressure was normal.  That means, no glaucoma.

The fluorescein dye (fluorescent orange dye that glows green under an ultraviolet light) was negative for cuts, scrapes, or ulcers on the eyes.

But wait! Before the orange glowing stuff, we test the tear production in the eyes.

maltese with a tiny strip of white paper tucked a little under his lower eyelid and a line a tear-stained blue to indicate progression of the tears in a minute.

Schirmer Tear Test for a Maltese Dog

Schirmer Tear Test

A small porous strip of white paper with millimeter lines marked on it is placed with the end 4 mm bent under the lower eyelid.  A blue dye in the bottom of the paper gets picked up by the tear liquid and carried on the paper.  We measure how far the tears travel in one minute.  They should travel 15-25 millimeters in a minute.  If they do not, there is reduced tear production.

Harry measured 6 mm of tears a minute in each eye.  Not enough tears!

People who have “dry eye” say it makes the corneal surface of the eye feel like there is sand stuck in your eye all the time!  It is uncomfortable, and the lack of normal tears makes bacterial and other infections take hold more easily than in a normal eye.

What is Dry Eye?

The fancy doctor word for dry eye is keratoconjunctivitis sicca, or “KCS” for short.  Either the tears stop and an infection sets in, or infection irritates the tear glands and ducts and they stop producing enough tears.  So the first step is to be certain there’s no infection, and remeasure the tears in a few days or a week to confirm if the dry eye remains.

If dry eye persists, be sure the dog does not have a reason for sluggish tears, like hypothyroidism, allergies, or an autoimmune disease.

Can I Treat Dry Eye at Home?

No, the treatment involves prescription medication.  The treatment for the dry eye is lifelong medicine that stops the immune system from attacking the tear glands so they can do their work and make tears!  Sometimes, a dog suffers a relatively mild case of KCS, and artificial tears or overnight tear drops can help.  But mostly, you’re kidding yourself if you think your dog is comfortable with the tear drops.  Ask anyone who suffers dry eye!  People will tell you after about an hour, they feel the abrasive sand-feeling return.  Can you put eye drops in your dog’s eyes every hour?

This treatment needs to be continued forever in most dogs.

Tru Tail

Benny the Shih Tzu had terrible dry eye, with thick leathery brown corneas and he was blind in both eyes.  He came to the animal hospital for a check-up, and his eyes were stuck shut with green pus, thick scabby material crusted on his eyelids, and the whites of his eyes were bloodshot.

“Isn’t the medicine working anymore?” asked Doc Truli.

“We stopped giving it,” said Benny’s parents.

“Why?” asked the Doc. (It can be expensive, maybe money was tight?)

“We figured he’s blind anyway, what does it matter?”

Here’s the point: Dry Eye hurts.  KCS is painful.  Treat the eyes even if your dog is blind.  Anything less is agony for your dog.

Harry’s Happy Ending

Harry returned one week later.  The antibiotic eye ointment helped, but he still was not producing enough tears.  The little Maltese started taking cyclosporin 2% eye drops several times a day (it varies, your vet has to prescribe the right timing for your dog.)  After 3 days, the eyes cleared up and he started eating better and playing again!  Harry felt normal again.  He will always need some medicine to keep his eyes comfortable and healthy.

Addendum October 2010

Based on reader emails, please note these additional possible causes of tear staining on a Maltese’ face.  Blocked tear ducts are possible.  Your veterinarian may need to sedate your Maltese in order to identify and treat a blocked tear duct.  Some Maltese (and other small breed dogs like Chihuahuas, Mini and teacup Poodles, Shih Tzu, Bichon, Yorkies, etc. actually are born either without the tear duct passageway being open, or with a tiny shallow pool in the bottom eyelid that directs tears onto the face, instead of down the tear duct to the inside of the nasal cavity (normal.)

Also, many Maltese express allergies to food or inhaled allergens through excessive tear staining and sometimes anal sacs that fill up too frequently (more than monthly).  Please see VirtuaVet’s story about a Pit Bull with Food Allergies to read about detailed step-by-step instructions for food allergy investigation at home!

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