Dry eye in the dog: topical ciclosporin and tacrolimus
7-year-old West Highland White Terrier with recurrent bilateral mucopurulent discharge that improves with antibiotics and returns when they are stopped. The corneas are dull and lustreless, with superficial vessels and some pigment.
| Parameter | Result | Reference |
|---|---|---|
| Schirmer tear test OD | 4 mm/min | ≥ 15 mm/min |
| Schirmer tear test OS | 6 mm/min | ≥ 15 mm/min |
| Fluorescein | Negative in both eyes | Negative |
What is the treatment of choice?
chevron_right Show answer and explanation
A. Continuous topical antibiotic to control the discharge
The infection is secondary to the lack of tears. The antibiotic only masks the problem, which returns as soon as it is stopped.
B. Artificial tears as the sole lifelong treatment
They are a good adjunct, but they neither treat the immune-mediated destruction of the lacrimal gland nor increase tear production.
C. Immediate parotid duct transposition
It is reserved for cases that fail after several months of proper medical treatment. Saliva is not tears and can leave mineral deposits on the cornea.
D. Topical ciclosporin every 12 hours with artificial tears (and antibiotic while infection persists), rechecking the Schirmer test at 4–8 weeks; if there is no response, topical tacrolimus
Correct. Ciclosporin halts the immune-mediated destruction of the gland and stimulates tear production; its effect takes weeks. Tacrolimus is the alternative when ciclosporin is not enough. Treatment is lifelong.
lightbulb Key takeaway
In a dog with recurrent mucopurulent conjunctivitis, always do a Schirmer test before the antibiotic. The response to ciclosporin is better the more functional gland remains, so start early and never stop.
Test yourself with 10 random questions
Ophthalmology · 100 questions, a different test every time
Related questions
Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.