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Keratoconjunctivitis sicca

**{{{Name|Keratoconjunctivitis sicca}}}**
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 ICD9           = 370.33, 710.2|
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 eMedicineSubj  = oph |
 eMedicineTopic = 695 |
 DiseasesDB     = 12155 |

}} Keratoconjunctivitis sicca (KCS), also called keratitissicca, xerophthalmia, dry eye syndrome, or simply dry eyes, is an eyediseasecaused by decreased tearproduction or increased tear film evaporation commonly found in humansand small animals. Keratoconjunctivitis sicca is Latinand the literal translation is "dryness of the corneaand conjunctiva".

Inhaltsverzeichnis

1 The disease in humans
- 1.1 Symptoms
- 1.2 Treatment
- 1.3 Causes
2 The disease in dogs
- 2.1 Breeds commonly affected by KCS
3 The disease in cats
4 References
5 See also

The disease in humans

Symptoms

In humans, the typical symptoms of keratoconjunctivitis sicca are burning and a sandy-gritty eye irritation that gets worse as the day goes on. The symptoms are often caused by a loss of water from the tears that results in tears that are too "salty" or hypertonic.

Treatment

The best treatment strategies are designed to rehydrate the tears and eye surface, and include hypotonic, electrolyte-balanced tears, punctal plugs, and moist chamber spectacles. The inflammation that occurs in response to tears film hypertonicity can be suppressed by mild topical steroidsor immunosuppressantssuch as cyclosporine, but these treatments have not been shown to help symptoms.

Causes

Keratoconjunctivitis sicca usually occurs in people who are otherwise healthy. It is more common with older age, because tear production decreases with age. In rare cases, it can be associated with rheumatoid arthritis, lupus erythematosus, Sjögren's syndromeand other similar diseases. It may also be caused by thermal or chemical burns, or (in epidemiccases) by adenoviruses. A number of studies have found that those with diabetesare more at risk for KCS. (PMID 15767060, PMID 15663232, PMID 15218664)

The disease in dogs

Keratoconjunctivitis sicca is common in dogs. Most cases are caused by a geneticpredisposition, but chronic conjunctivitis, canine distemper, and drugs such as sulfasalazineand trimethoprim-sulfonamidealso cause the disease. Symptoms include eye redness, a yellow or greenish discharge, ulcerationof the cornea, pigmentedcornea, and blood vessels on the cornea. Diagnosis is made by measuring tear production with a Schirmer tear test. Less than 15 millimeters of tears produced in a minute is abnormal.

Tear replacers are a mainstay of treatment, preferably containing methylcelluloseor carboxymethyl cellulose. Cyclosporine stimulates tear production and acts as a suppressant on the immune-mediatedprocesses that cause the disease. Topical antibioticsand corticosteroidsare sometimes used to treat secondary infections and inflammation. A surgery known as parotid ducttransposition is used in some extreme cases where medical treatment has not helped. This redirects the duct from the parotid salivary glandto the eye. Salivareplaces the tears. Dogs suffering from cherry eyeshould have the condition corrected to help prevent this disease.

Breeds commonly affected by KCS

Cavalier King Charles Spaniel
English Bulldog
Lhasa Apso
Shih Tzu
West Highland White Terrier
Pug
Bloodhound
Cocker Spaniel
Pekingese
Boston Terrier
Miniature Schnauzer
Samoyed

The disease in cats

Keratoconjunctivitis sicca is uncommon in cats. Most cases seem to be caused by chronic conjunctivitis, especially secondary to feline herpesvirus. Diagnosis, symptoms, and treatment are similar to dogs.

References

Gelatt, Kirk N. (ed.)(1999). Veterinary Ophthalmology (3rd ed.). Lippincott, Williams & Wilkins. ISBN 0-683-30076-8