Keratoconjunctivitis sicca, dry, and enucleation

This wonderful older dog with “dry eye” in the left eye. The treatment philosophies, realities, and some of the decisions that going to a case like this.

This older, but not old, Boston terrier has a condition called “dry eye” Also known as keratoconjunctivitis Sica or KCS.
For reasons we don’t understand, the body develops an immune response to the tear glands causing the eye to dry out. Oily secretions become thick waxy secretions and infections take over the eye, eventually, ruining the cornea and often rendering the eye sightless.
Medications can be used through the course of the problem and may make an improvement in the case
but quite often, after years of battling these cases, the chronic inflammation and damage to the eye renders it sight less.
At that point, the owner is going to a lot of trouble with medication and expense, the dog is living with a stinging, dry eye which is uncomfortable as well as unsightly.
So sometimes, removal of the eye is certainly aggressive, but curative. Keeping in mind that the eye is already without vision and is simply a nuisance. And this dog‘s case, it has vision in the other eye.
It bears mentioning that there is another procedure that can be done however I have never seen it. That is redirecting a salivary duct from the mouse, up the side of the face and onto the eye. The saliva flows over the eye keeping it moist and ostensibly reducing the incidence of infection.
Little good it would do this dog has the corneal lesions suffered by this dog have already rendered it sightless but, knowing that this salivary duct transposition procedure is available for dogs with dry eye, that could benefit from the surgery, is a good thing.
But for this dog, if you think about it, enucleation of the eye resulting in complete restoration of comfort, isn’t a bad idea. And, while it seems aggressive even barbaric, it does eliminate the maintenance of a sightless and uncomfortable eye.
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