Daytime profile of the intraocular pressure and tear production in normal dog

Objective  To evaluate the circadian rhythms of intraocular pressure (IOP) and tear production in dog exposed to a natural photoperiod.
Animals studied  We used 12 clinically healthy Beagles dog housed under natural photoperiod at indoor temperature and humidity.
Procedure  Intraocular pressure and Schirmer tear test (STT) I were measured every 4 h over a 48-h period in both eyes in each animal. Statistical analysis of the data was performed by one-way repeated-measures anova , Student's t -test, and single cosinor method.
Results  On each day, there was a highly significant effect of time on both parameters. A statistically significant difference of STT I values was observed comparing left and right eyes ( P  < 0.0001). Robust daily rhythms were observed for both parameters, IOP values showed diurnal acrophase (left eye: 09:33 ± 00:50 h; right eye: 09:25 ± 00:22 h), while STT I values showed nocturnal acrophase (left eye: 20:27 ± 00:46 h; right eye: 20:00 ± 00:05 h).
Conclusion  This study has demonstrated circadian rhythms in both IOP and STT I.     

Tear production in canine neonates – evaluation using a modified Schirmer tear test

Purpose The ability of human newborns to produce tears has been a subject of controversy in the literature since the mid‐20th century, and there has been considerable debate as to whether they are able to produce tears. Recently, it was established that total tear secretion (reflex + basal) in full‐term infants is similar to those of adults whereas both reflex and basal tear production is reduced in premature babies. The objectives of this study were to assess whether newborn dogs have measurable aqueous tear production at the fourth week of life and to evaluate a modified Schirmer tear test (mSTT) as a useful method for measuring neonatal tear production in dogs. Methods Thirty four‐week‐old healthy puppies from six litters were evaluated. A control group was composed of 10 normal adult dogs. The mSTT strips were obtained by cutting a 5 mm‐wide strip in half (making two 2.5 mm‐wide strips). The mSTT1 was performed in puppies and adult dogs. Values were compared using t‐tests. Results In neonates, the average value for the mSTT1 was 13.6 ± 3.07 (range = 7–19 mm/min), which was significantly lower in neonates than in adult dogs (23.25 ± 3.5, range = 17–30 mm/min, P < 0.0001). Conclusions Canine neonates do produce tears by the fourth week of life, which can be successfully measured with the mSTT. This report established for the first time that canine neonates have significantly reduced total (reflex + basal) tear secretion compared to adults.     

Analysis of tear uptake by the Schirmer tear test strip in the canine eye

OBJECTIVE: To analyze the uptake of tears in a Schirmer tear test (STT) in vitro and in vitro. MATERIALS AND METHODS: Uptake of fluid by Schirmer tear test strips was studied in vitro by examining fluid uptake over time from an unlimited fluid supply as well as with specific fluid volumes applied to the test strip. Uptake of fluid by Schirmer tear test strips was evaluated in a population of 100 ophthalmologically normal dogs together with a group of 40 dogs with tear film abnormalities such as keratoconjunctivitis sicca (KCS) or epiphora. Each animal was given a full ophthalmic examination followed by a standard Schirmer tear test extended over between 3 and 5 min with the STT reading recorded every 5 s and plotted over time. To determine the effect of ocular irritation by the test strip, uptake of tears by test strips was determined before and after topical anesthesia in 20 dogs. RESULTS: In vitro examination of fluid uptake by the STT strips showed an initial rapid uptake followed by a gradual reduction in rate of uptake. Temporal evaluation of STT in vivo showed a similar rapid initial uptake of tear fluid, followed in the majority of cases by a sudden change to a steady state uptake of fluid. The initial gradient was 29.3 +/- 16.9 mm/min followed by a steady state uptake of 5.2 +/- 2.3 mm/min in normal dogs and 1.9 +/- 1.3 mm/min in dogs with KCS. This corresponds to a steady state tear turnover of 7.8 +/- 3.4 microL/min in normal dogs and 2.8 +/- 1.9 microL/min in animals with KCS. Dogs with nasolacrimal blockage and resultant epiphora showed a high initial gradient but final gradients were not statistically different from those of normal dogs. Discussion and conclusions Temporal evaluation of tear uptake by the STT shows substantial differences in rate of tear uptake at different time-points during the period of the test. RESULTS: of this study suggest that the initial rapid rise in STT value represents uptake from the tear lake followed by a slower tear uptake of tears from steady state tear production. Temporal examination of the Schirmer tear test allows a more precise evaluation of tear production than the standard STT measuring tear uptake in 1 min, together with estimation of the contribution to the test strip tear uptake of tears from the residual tear lake volume and those from continual tear production.     

Effect of short-term diphenhydramine administration on aqueous tear production in normal dogs

Objective To perform a randomized, placebo‐controlled, masked clinical trial using a cross‐over design to determine the effect of oral diphenhydramine on aqueous tear production in normal dogs. Animals studied Seventeen dogs with normal ophthalmic examinations. Procedures Baseline tear production was established for each dog by performing Schirmer tear test I (STT I). Dogs received 20‐day treatment courses of both oral diphenhydramine and placebo solutions with a 10‐day washout period between treatment periods. Each dog was randomly assigned to receive diphenhydramine or placebo at the outset of the study. Measurements of STT I values were measured at regular intervals during the study and were conducted at the same time of day throughout the study to control for diurnal variations in tear production. The significance of the impact of diphenhydramine treatment on the quantity of aqueous tear production, as determine by STT results over time, was evaluated using regression analysis with appropriate transformation. Results Statistical comparisons at each measurement time, including baseline measurements between control and treatment groups, revealed no significant differences. Mean STT I levels also did not differ significantly at any measurement time compared to baseline for treatment or control groups. Conclusions Short‐term administration of oral diphenhydramine does not result in a significant decrease in aqueous tear production in normal dogs.     

Effect of lacrimal punctal occlusion on tear production and tear fluorescein dilution in normal dogs

OBJECTIVE: To evaluate effects of lacrimal punctal plugs positioned in either the upper, lower, or combination of upper and lower lacrimal canaliculi on plug retention and tolerance; tear production, as measured by the Schirmer tear test; and the dilution of fluorescein within the tear film in normal dogs. MATERIAL AND METHODS: Lacrimal punctal plugs were positioned in the lower, upper, or combination of lower and upper plugs in six laboratory-quality Beagles under topical anesthesia. Retention of plugs was evaluated daily from 8 to 23 days by visual inspection and slit-lamp biomicroscopy. Schirmer tear tests (STT 1 without topical anesthesia) were performed at 48-h intervals. Dilution of fluorescein was determined at 5- and 45-min post-fluorescein instillations once weekly. RESULTS: Lacrimal punctal plugs of 0.4 and 0.6 mm in diameter were retained for 14 (lower plugs: 100%) and 23 days (75%), and for the upper plugs at 8 days less often (75%), and were infrequently locally nonirritating. Combination of lower and upper plugs seemed to adversely affect retention of either plug. When loss of the plugs occurred, a next larger size plug was necessary suggesting some stretching of the lacrimal canaliculi occurred. Pre- and postplug placement STT results indicated no change with lower and combination lacrimal punctal plugs, but decreased levels following upper lacrimal punctal plugs. Tear fluorescein levels at 5 and 45 min in control eye (no punctum plugs) were 3.39% and 0.14%, respectively. With lower, upper, and the combination of lower and upper lacrimal puncta plugs, tear fluorescein levels at 45 min were higher than the controls (lower: 0.76%; upper: 0.45%, and combination 0.56%). CONCLUSION: Lacrimal punctal silicone plugs are retained for 8-23 days in the lower, upper, and combined lower and upper canaliculi at high rates. Effects on STT levels appear limited. Fluorescein within the tear film persists longer with all different positioned lacrimal punctum plugs than in the control eyes.     

Effect of acepromazine or xylazine on tear production as measured by Schirmer tear test in normal cats

Objective  To evaluate the effect of acepromazine or xylazine on Schirmer tear test 1 results in clinically normal cats.
Animals  Sixteen healthy cross-breed cats.
Procedure  The animals were randomly divided into two groups of eight cats each. The first group was sedated with acepromazine alone (0.2 mg/kg) and the second group received only xylazine (2 mg/kg). All cats had Schirmer tear test (STT) readings taken prior to sedation and at 15 and 25 min postsedation.
Results  Sedation with acepromazine or xylazine in cats with normal pre-sedation STT 1 values caused a statistically significant decrease in mean values of tear production in both groups. In acepromazine group the mean ± SEM STT at T₁₅ and T₂₅ were 4.31 ± 0.98 ( P  < 0.001) and 5.18 ± 1.07 ( P  = 0.002). The post-treatment mean ± SEM values in xylazine group were 2.18 ± 0.97 ( P  < 0.001) and 2.62 ± 1.17 ( P  = 0.001) at 15 and 25 min respectively. Comparison between T₁₅ and T₂₅ in acepromazine group ( P  = 0.49) and xylazine group ( P  = 0.56) revealed no significant differences.
Conclusion  These observations indicate that both acepromazine or xylazine significantly reduced tear production in clinically normal cats. In cats, clinicians should measure STT values prior to utilizing acepromazine or xylazine as sedatives in order to accurately assess the results. Moreover, sterile ocular lubricant or tear replacement should be used as a corneal protectant during sedation with these drugs.     

Effects of medetomidine and medetomidine-butorphanol combination on Schirmer tear test 1 readings in dogs

Medetomidine is a commonly used sedative in veterinary medicine whether administered alone or in combination with an opioid such as butorphanol. There are no previous studies that look at the effects of this drug on sequential Schirmer tear test (STT) 1 readings in dogs, including effects on tear production after reversal of the drug. The present study looked at two groups of 10 dogs each that were sedated with intravenous medetomidine or a combination of medetomidine and butorphanol. All dogs had tear readings taken presedation, 15 min postsedation, and 15 min after reversal of medetomidine with atipamezole. Results revealed that intravenous sedation with medetomidine and medetomidine-butorphanol in dogs with no history of ophthalmic disease and presedation STT 1 readings above 15 mm/min, causes a significant decrease in tear production that is measurable at 15 min postsedation. Readings returned to near presedation values within 15 min postreversal in most cases. It is therefore recommended that all eyes be treated with a tear substitute from the time the sedative is given until at least 15 min after reversal.     

Effects of trimethoprim-sulfadiazine on tear production and the fluctuations of Schirmer tear test values in horses

The objectives of this study were to observe the effects of trimethoprim-sulfadiazine on equine tear production and to determine normal fluctuations in Schirmer tear test (STT) values in horses. A randomized, placebo-controlled, blinded clinical trial measuring STT values in 15 horses over an 8-week period was performed. The treatment group (eight horses) received 30 mg/kg trimethoprim-sulfadiazine orally once a day and the control group (seven horses) received placebo (flour) at the same time. All horses were housed outdoors throughout the study. Schirmer tear test values were measured at 0, 2, 4, 6 and 8 weeks, and 4 weeks after discontinuation of treatment. There were no significant differences in tear production between the treated and control groups. Fluctuations in STT were observed and may result from individual and environmental variations. Trimethoprim-sulfadiazine did not decrease tear production in the horses in this study. Horses normally experience periodic fluctuations in STT values.     

Effect of topical tropicamide on tear production as measured by Schirmer's tear test in normal dogs and cats

Objective To evaluate the effect of a single dose of topical 1% tropicamide on tear production as measured by the Schirmer tear test (STT) in the normal dog and cat. Material and methods Twenty‐eight dogs and 32 cats received 50 µl : l of 1% tropicamide in one eye and the opposite eye served as the control. STTs were performed immediately before instillation of tropicamide and then at 1, 4, 8 and 24 h post drug instillation. STT results were compared between the control and treated eyes at the different times. Results Aqueous tear production in dogs, measured by STT, was not significantly reduced. The mean ± SEM STTs for the baseline time for control and tropicamide‐treated eyes were 19.9 ± 0.8 and 20.3 ± 0.8 mm wetting/min, respectively. For the control eyes, the subsequent mean ± SEM STT levels were 20.3 ± 0.9 (1 h), 21.1 ± 0.8 (4 h), 20.1 ± 0.9 (8 h), and 18.7 ± 0.7 (24 h). For the tropicamide‐treated eyes, the subsequent mean ± SEM STT levels were 19.4 ± 0.9 (1 h), 19.3 ± 0.9 (4 h), 20.0 ± 0.9 (8 h), and 18.4 ± 0.8 (24 h). Aqueous tear production of both eyes was significantly reduced in cats at 1 h but returned to baseline by 4 h post tropicamide instillation. The mean ± SEM STT levels for the baseline time in cats for control and tropicamide‐treated eyes were 14.9 ± 0.8 and 14.7 ± 0.8 mm wetting/min, respectively. Subsequent mean ± SEM STT levels for the control eyes were 6.4 ± 1.1 (1 h), 11.9 ± 1.0 (4 h), 13.9 ± 0.8 (8 h), and 16.4 ± 1.0 (24 h). For the tropicamide‐treated eyes, the subsequent mean ± SEM STT levels were 5.3 ± 0.8 (1 h), 10.2 ± 0.8 (4 h), 14.7 ± 1.0 (8 h), and 16.6 ± 1.0 (24 h). Conclusion Single dose 1% tropicamide does not significantly lower tear production rates, as measured by the STT, in normal dogs. However, in normal cats single doses of 1% tropicamide in one eye cause significant reductions in tear production of both eyes at 1 h that recovered to baseline levels by 4 h.     

Effect of age, gender, weight, and time of day on tear production in normal dogs

OBJECTIVE: To investigate the effects of age, weight, gender, and of time of day on tear production in normal dogs. ANIMALS: studied One hundred ophthalmoscopically and systemically unremarkable dogs. PROCEDURE: Schirmer tear tests (STT) were performed every 2 h during the day on one randomly chosen eye of each of 100 dogs. RESULTS: There was a statistically significant effect of time of day and age on the STT measurement. The mean STT decreased by 0.4 mm for every 1 year that age increased (P=0.007). Mean STT values taken at 10:00 am were 0.7 mm lower than values taken at 4:00 pm (P=0.04). CONCLUSIONS: Tear production decreases with age in the normal dog. In this population of dogs the largest difference was between the 10:00 am and the 4:00 pm STT measurements, but this still only amounted to 0.7 mm. This value is unlikely to be of clinical significance in the diagnosis of keratoconjunctivitis sicca (KCS).     

Effects of intramuscular sedative and opioid combinations on tear production in dogs

The effect of commonly used sedation protocols on tear production rate was evaluated in dogs. Schirmer I tear tests were examined before and after intramuscular injection of acepromazine and oxymorphone (ACE + OXY; n  = 7), diazepam and butorphanol (DIA + BUT; n  = 8), and xylazine and butorphanol (XYL + BUT; n  = 8). Two Schirmer I tear tests were also performed 15–25 min apart in dogs which received no sedative drugs (control; n  = 4). Tear production rate decreased to 15 ± 2, 17 ± 1, and 6 ± 1 mm min⁻¹, respectively, while control animals averaged 21 ± 2 mm min⁻¹ at the same time point. Because XYL + BUT profoundly decreased tear production rate, we evaluated the two drugs separately. While BUT mildly decreased tear production when given alone to dogs (18 ± 1 mm min⁻¹; n  = 5), xylazine had no effect on tear production. Thus it appears that the two agents act synergistically to decrease tear production rate in dogs. Moreover, sterile ocular lubricant or tear replacement should be used during XYL + BUT sedation.     

Schirmer tear tests and intraocular pressures in conscious and anesthetized koalas (Phascolarctus cinereus)

Objective To estimate mean Schirmer tear test (STT) and intraocular pressure (IOP) values in healthy koalas both conscious and anesthetized. Methods Data were gathered from koalas in Victoria, Australia. Conscious examinations were performed on captive koalas. Free‐ranging (wild) koalas were examined under anesthesia. Anesthesia was induced using alfaxalone, and animals were maintained on oxygen and isoflurane if required. All animals were healthy and had no surface ocular pathology detectable during slit lamp biomicroscopy. STT I tests were performed using commercial STT test strips placed in the lower fornix for 1 min. IOP was measured using an applanation tonometer after topical anesthesia. The higher value of the two eyes for both STT and IOP was analyzed. STT was measured in 53 koalas (34 conscious, 19 anesthetized) and IOP was measured in 43 koalas (30 conscious, 13 anesthetized). A two‐sample t‐test was used to compare means. A P‐value <0.05 was regarded as significant. Mean ± SD is presented. Results The mean higher STT in conscious koalas was 10.3 ± 3.6 mm wetting/min and in anesthetized koalas it decreased to 3.8 ± 4.0 mm wetting/min (P < 0.0001). The mean higher IOP in conscious koalas was 15.3 ± 5.1 mmHg, and in anesthetized koalas it was 13.8 ± 3.4 mmHg (P = 0.32). There was no effect of sex on either STT or IOP. Conclusions The mean and SD of STT and IOP values for koalas both conscious and anesthetized were reported. The mean STT was significantly reduced by alfaxalone anesthesia.