Schirmer tear test, phenol red thread tear test, eye blink frequency and corneal sensitivity in the guinea pig

OBJECTIVE: To establish reference values for Schirmer tear tests (STT) I and II, phenol red thread (PRT) tear test and eye blink frequency, and to determine corneal sensitivity for normal guinea pigs. ANIMALS STUDIED: One hundred and eight eyes of 54 adult Duncan-Hartley guinea pigs. PROCEDURE: Schirmer tear test (STT) I and then STT II were performed in 36 guinea pigs. PRT and STT I were compared in 18 adult Duncan-Hartley guinea pigs. Corneal sensitivity was determined in 23 guinea pigs by evaluating the corneal touch threshold (CTT) of five different regions using a Cochet-Bonnet esthesiometer. Eye blink frequency was measured in 10 guinea pigs over a period of 20 min and in 17 guinea pigs over a period of 10 min. RESULTS: Mean STT I was 0.36 mm +/- 1.09 mm (wetting/min) and mean STT II was 0.43 mm +/- 1.29 mm (wetting/min). There was no significant difference between mean STT I and mean STT II (P = 0.79). The mean PRT-value was 16 +/- 4.7 mm (wetting/15 s), and the mean STT I-value in the same guinea pigs was 0.6 +/- 1.83 mm (wetting/min). Corneal sensitivity was significantly higher in the center than in the four limbal regions. The mean CTT for central, ventral, nasal, temporal and dorsal regions was 2, 1.7, 1.7, 1.7 and 1.6 cm or 3.7, 5.2, 5.6, 5.7 and 6.4 g/mm(2), respectively. Eye blink frequency was between two to five (mean 3.4 +/- 1.04) blinks per eye over 20 min in guinea pigs in their home environment, while in handheld and restrained guinea pigs eye blink frequency showed a variation between 0 and 17 blinks per eye (mean 3.24 +/- 3.64 blinks per eye) over 10 min. CONCLUSIONS: As there were no significant differences between STT I and STT II results, reflex tear secretion in the guinea pig may not exist. The most likely explanation is a lower corneal sensitivity in the guinea pig than in other species, such as cats, dogs and horses. Because of the small amount of tears, PRT is the preferred test for tear measurement in the guinea pig.     

Determination of reference values for intraocular pressure and Schirmer tear test in clinically normal ostriches (Struthio camelus)

The purpose of this study was to establish normal physiologic reference values for intraocular pressure (IOP) and Schirmer tear test (STT) results in clinically normal ostriches (Struthio camelus). Twenty ostriches of both sexes, 10 juveniles (1.5-2 yr of age) and 10 adults, were included in this study. Complete ophthalmic examination was performed prior to this investigation. STT was performed by inserting a standard sterile STT strip over the ventral lid margin into the ventral conjunctival sac for 60 sec. Following the STT, IOP was measured using applanation tonometry with the Tono-Pen Vet tonometer after topical instillation of one drop of 0.5% proparacaine ophthalmic solution. The mean +/- SD and range of Tono-Pen readings of IOP for all birds was 18.8 +/- 3.5, with a range of 12-24. Mean IOP in juvenile ostriches was 19.7 +/- 3.6. Mean IOP in adult ostriches was 16.9 +/- 2.9. There was no statistically significant difference between young and adult birds (P = 0.07). The mean STT values in the present study were 16.3 +/- 2.5 mm/1 min when measurements from both eyes were averaged. Mean STT in juvenile and adult ostriches was 15.4 +/- 1.8 and 17.2 +/- 2.9 mm/1 min, respectively. There was no statistically significant difference between young and adult birds (P = 0.11). No statistically significant differences between genders were found for any of the results (P > or = 0.41). In conclusion, this study provides normal reference range values for STT and IOP in clinically healthy ostriches.     

Evaluation of results for Schirmer tear tests conducted with and without application of a topical anesthetic in clinically normal dogs of 5 breeds

OBJECTIVE: To evaluate, for clinically normal dogs, results of Schirmer tear tests in eyes without topical anesthetic (STT) and to detect differences associated with breed, sex, age, day, and time of day in eyes in which STT was performed after use of topical anesthetic (STTa). ANIMALS: 41 Beagles, 43 Labrador Retrievers, 25 Golden Retrievers, 26 English Springer Spaniels, and 22 Shetland Sheepdogs. PROCEDURE: Beagles had STT and STTa values measured twice daily for 5 days. Client-owned dogs of 4 other breeds had STT and STTa values measured once. RESULTS: Mean +/- SD values of Beagles for STT and STTa were 20.2 +/- 2.5 and 3.8 +/- 2.7 mm/min. Mean values for STT and STTa were as follows: Labrador Retriever, 22.9 +/- 4.1 and 9.6 +/- 3.8 mm/min; English Springer Spaniel; 20.7 +/- 3.2 and 5.4 +/- 3.4 mm/min; Golden Retriever, 21.8 + 3.7 and 8.8 +/- 3.1 mm/min; and Shetland Sheepdog, 15.8 +/- 1.8 and 3.6 +/- 2.8 mm/min. Overall mean values for STT and STTa were 20.2 +/- 3.0 and 6.2 +/- 3.1 mm/min. Differences for STT and STTa were detected among breeds, but significant differences were not associated with sex or age within each breed or in overall values for all dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Results for the STT reported here compare favorably with reported values, except for results of Shetland Sheepdogs; however, results for the STTa differ dramatically from reported values. Clinicians should consider effects attributable to breed when evaluating results of STT and STTa in dogs.     

Reference values for selected ophthalmic diagnostic tests and clinical characteristics of chinchilla eyes (Chinchilla lanigera)

Objective To establish reference values for the Schirmer tear test I (STT I), the phenol red thread tear test (PRTT), the intraocular pressure (IOP) with rebound tonometry, to determine the corneal sensitivity for healthy chinchillas, and to describe clinical aspects of normal chinchilla eyes. Animals One hundred and twenty‐two eyes of 61 healthy pet chinchillas of different age and gender were investigated. Procedures A full ophthalmic exam including slit lamp biomicroscopy, ophthalmoscopy, measurement of STT I, PRTT, determination of the corneal touch threshold (CTT), and the measurement of the IOP (TonoVet®) was performed. The normal appearance of the lid, the iris, the lens, the fundus, and the optic nerve disc was evaluated. Results The results of the STT I were very low and not reliable, and the measurement was discontinued. The median value of PRTT was 14.0 mm wetting/15 s (mean 14.6 ± 3.5 mm wetting/15 s). The median CTT was 32.5 mm (mean 31.2 ± 7.0 mm) respectively 1.2 g/mm² (mean 1.5 ± 0.9 g/mm²). The median IOP was 3.0 mmHg (mean 2.9 ± 1.8 mmHg). The predominating iris color was brown. The fundus pigmentation varied. Few lens alteration were seen in otherwise healthy chinchilla eyes. Most chinchillas had myelinated discs. Optic nerve cupping was present in 62% of the animals. Conclusion Because of the small amount of tears, the PRT test is recommended for tear measurements in chinchillas. The IOP in chinchillas seems to be quiet is low in comparison to other rodents.     

Reference values for Schirmer tear tests I and II in clinically normal pigs

Objective To determine reference values for Schirmer tear tests I and II in clinically normal pigs. Animal studied Twenty clinically normal Landrace pigs (10 males and females) without ocular abnormalities were used in this study. Procedures In all pigs, Schirmer tear tests (STT) I and II were performed by using a sterile Schirmer tear test standardized strip (Schirmer‐Tränentest^®, Germany) placed in the lower conjunctival fornix for 1 min. Results For each test (STT I and STT II), no differences were observed between the right and left eyes (P ≥ 0.5). The mean ± SD STT I value was 15.6 ± 3.7 mm/min (range, 10–22 mm/min), while the mean STT II value was 12.4 ± 3.8 mm/minute (range, 5–18 mm/min). The mean STT II value was significantly lower than the STT I level (P < 0.001). Animal gender did not have a significant effect on STT I and II values (P = 0.52). The mean ± SD STT I/II values of 10 juvenile pigs were significantly lower than the mean ± SD STT I/II values of 10 adult pigs (P < 0.001). Conclusions This study of 20 Landrace pigs provided valuable information on normal STT I/II in this species. Knowledge of normal STT reference values in pigs enables the clinician to evaluate corneal pathology and diagnose tear deficiency syndromes with greater accuracy.     

Keratoconjunctival effects of diabetes mellitus in dogs

OBJECTIVES: To compare Schirmer tear test (STT) values, corneal sensitivity, tear film break up times (TFBUTs), and tear glucose concentrations in relation to conjunctival microflora, and conjunctival cytologic and histologic findings among diabetic cataractous, nondiabetic cataractous, and nondiabetic noncataractous dogs. Procedures Fifteen dogs in each category underwent neuro-ophthalmic examination; aerobic, anaerobic and fungal conjunctival cultures; assessment of corneal touch threshold (CTT), STT, tear glucose, TFBUT; and conjunctival cytology and histology (in certain cases only). Degree of cataract and uveitis were critically graded. Glycemic control was estimated using serum fructosamine and glycosylated hemoglobin. RESULTS: STT values were significantly lower in diabetic cataractous than nondiabetic noncataractous dogs. CTT of diabetic cataractous dogs was significantly lower than that of nondiabetic noncataractous dogs. Mean TFBUTs were significantly less in diabetic cataractous dogs than nondiabetic cataractous and nondiabetic noncataractous dogs. Tear glucose concentrations were significantly higher in diabetic cataractous dogs than nondiabetic cataractous and nondiabetic noncataractous dogs. Conjunctival microbial isolates did not differ among groups. There were no significant differences in degree of cataract or uveitis between diabetic cataractous and nondiabetic cataractous groups. There was mild submucosal inflammatory infiltrate in conjunctival specimens from diabetic dogs. Conjunctival epithelial dysplasia and/or squamous metaplasia was/were detected in conjunctival biopsies of 5/7 diabetic dogs. Reductions in conjunctival goblet cell (GC) densities were noted in 4/7 diabetic dogs; there were no significant differences in mean GC densities among the three groups. CONCLUSIONS: Diabetic cataractous dogs have significantly altered keratoconjunctival characteristics compared to nondiabetic cataractous and nondiabetic noncataractous dogs.     

Evaluation of aqueous tear production in dogs following general anesthesia

Pre- and postanesthetic Schirmer tear test (STT) values were measured in 46 dogs. All subjects had normal preanesthetic STT values (18.3 +/- 2.8 mm per min in the left eye [OS] and 18.3 +/- 3.0 mm per min in the right eye [OD]). Significant differences were found between pre- and postanesthetic STT values. Significant decreases in tear production were evident for up to 24 hours following the anesthetic event. Subject age did not significantly influence the results. Duration of anesthesia significantly affected the rate of return to preanesthetic STT values, with anesthetic events greater than two hours in duration having a prolonged effect as compared to anesthetic events less than two hours in duration. Anticholinergic administration prior to or during anesthesia further lowered postanesthetic STT values.     

Effects of cyclophotocoagulation with a neodymium:yttrium-aluminum-garnet laser on corneal sensitivity,intraocular pressure,aqueous tear production,and corneal nerve morphology in eyes of dogs

OBJECTIVE: To determine effects of cyclophotocoagulation via administration of 100 J with a neodymium:yttrium aluminum garnet (Nd:YAG) laser on corneal touch threshold (CTT), intraocular pressure (IOP), aqueous tear production, and corneal nerve morphology in eyes of dogs. ANIMALS: 15 dogs. PROCEDURE: Noncontact Nd:YAG laser was transsclerally applied (10 applications; 25 W for 0.1 seconds for each application to each of 4 quadrants) to the ciliary body of the left eye of 15 dogs; the right eye was the control eye. Corneal integrity, CTT, tear production as measured by the Schirmer tear test (STT), and IOP were evaluated for 14 days following laser treatment. On day 14, dogs were euthanatized, eyes harvested, and corneas stained with gold chloride. Major nerve bundles were analyzed by use of a drawing tube attached to a light microscope, and maximum diameters were measured by use of image analysis software. RESULTS: All laser-treated eyes had significantly higher CTT values, compared with control eyes. Six of 15 laser-treated eyes developed ulcerative keratitis. On most days, IOP was significantly lower in laser-treated eyes in both morning and evening. Laser-treated eyes had a significant decrease of approximately 1 nerve bundle/corneal quadrant. Values for STT or nerve bundle diameters did not differ significantly. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of 100 J with a Nd:YAG laser effectively reduced IOP while increasing CTT and caused a significant decrease in number, but not diameter, of major corneal nerve bundles. Nerve damage and corneal hypoesthesia are etiologic factors in ulcerative keratitis following Nd:YAG cyclophotocoagulation.     

Effect of topical 0.02% tacrolimus aqueous suspension on tear production in dogs with keratoconjunctivitis sicca

Objective To investigate the effect of 0.02% tacrolimus in aqueous suspension on tear production in dogs with keratoconjunctivitis sicca (KCS). Animals studied One hundred five dogs diagnosed with KCS [Schirmer tear test (STT) ≤ 10 mm/min and clinical signs of dry eye]. Eyes with marginally decreased STT (11 ≤ 15 mm/min) and clinical signs of dry eye were also evaluated. Procedure The investigation was conducted in two parts: an initial efficacy study and a subsequent double blinded controlled study. In the efficacy study, the effect of topical tacrolimus (formerly FK‐506) on tear production in dogs with primary KCS was evaluated. Dogs were divided into four categories: 1) 59 eyes (38 dogs) naïve to tear stimulation therapy with initial STT ≤ 10 mm/min; 2) 28 eyes (21 dogs) naïve to tear stimulation therapy with initial STT 11 ≤ 15 mm/min; 3) 30 eyes (15 dogs) maintained successfully on CsA therapy; 4) 47 eyes (24 dogs) unresponsive to CsA therapy. STT and clinical signs were evaluated prior to and after 6 to 8 weeks of twice daily tacrolimus administration. Tacrolimus was substituted for CsA therapy in categories 3 and 4. The controlled study compared the effect of topical tacrolimus in aqueous suspension to administration of the aqueous carrier alone on tear production in 20 dogs with primary KCS. Results In the efficacy study, STT increased by 5 mm/min in 84.7%, 25.0%, 26.7% and 51.1% of eyes in categories 1, 2, 3 and 4 respectively after tacrolimus administration. Eighty‐three percent of eyes with extremely low initial STT (≤ 2 mm/min), increased 5 mm/min after tacrolimus. In the controlled study, STT increased by 5 mm/min in 7/10 dogs (14/20 eyes) that received tacrolimus and in none of the 10 dogs that received aqueous carrier alone. Dogs receiving just the aqueous carrier were subsequently treated with tacrolimus, and STT increased 5 mm/min in 9 dogs (18/20 eyes) after administration. Conclusions Twice daily administration of 0.02% tacrolimus in aqueous suspension effectively increased tear production in dogs with KCS. Topical tacrolimus is a promising alternative to topical CsA for treatment of KCS and may be beneficial in patients with less than optimal response to topical CsA.     

Tear film breakup times in young healthy cats before and after anesthesia

The objectives of this study were: (i) to determine tear film breakup times (BUTs) in young healthy cats; (ii) to determine tear film BUTs in feline eyes within 8-20 h following general anesthesia; (iii) to determine if tear film BUTs vary significantly preoperatively when compared with values obtained 8-20 h postoperatively; (iv) to determine if Schirmer tear test (STT) values correlate with tear film BUTs in young healthy cats; and (v) to determine if the isolation of particular etiologic agents from conjunctival swabs of healthy cats affects tear film BUTs. We studied eighteen healthy Domestic Short-haired (n=14) and Domestic Long-haired (n=4) cats, with normal ocular examinations, ranging in age from 0.5 to 3 years. Complete ophthalmic examinations, including tear film BUTs, were performed on all cats. Conjunctival swabs from each eye of all cats and blood samples from all cats were collected and submitted for polymerase chain reaction screening for feline herpes virus, Chlamydophila felis, Mycoplasma spp., and calicivirus. In 10 of 18 cats, STT values and tear film BUTs were measured before general anesthesia was administered and again within 8-20 h following the end of anesthesia. Mean preanesthesia tear film BUTs for all 18 cats were 17.4+/-4.6 s OD and 16.0+/-4.5 s OS. Mean postanesthesia tear film BUT results were 12.5+/-4.3 and 13.1+/-4.0 s OD and OS, respectively. Postanesthesia tear film BUTs were significantly more rapid than those measured before anesthesia (OD only). There was also a positive correlation, both before and after anesthesia, between STT values in both eyes (OU) and tear film BUTs OU. The isolation or lack of isolation of conjunctival microorganisms using PCR did not significantly affect tear film BUTs. Mean tear film BUT in young healthy domestic cats is 16.7+/-4.5 s. Tear BUT is positively correlated with STT values. Although mean tear film BUTs OD at 8-20 h following anesthesia were more rapid than preanesthesia values, this difference did not appear clinically relevant.     

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.     

Normal ocular features, conjunctival microflora and intraocular pressure in the Canadian beaver (Castor canadensis)

Objective The aim of the study was to assess the ocular features, normal conjunctival bacterial and fungal flora, and intraocular pressure (IOP) in the Canadian beaver (Castor canadensis). Sample population Sixteen, apparently healthy beavers with no evidence of ocular disease, and live‐trapped in regions throughout Prince Edward Island. Procedures The beavers were sedated with intramuscular ketamine (12–15 mg/kg). Two culture specimens were obtained from the ventral conjunctival sac of both eyes of 10/16 beavers for aerobic and anaerobic bacterial and fungal identifications. The anterior ocular structures of all beavers were evaluated using a transilluminator and slit lamp biomicroscope. Palpebral fissure length (11/16 beavers), and horizontal and vertical corneal diameters (10/16 beavers) were measured. IOPs were measured in both eyes of 11/16 beavers using applanation tonometry. Both eyes of 3/16 beavers and one eye of 1/16 beavers were dilated using topical tropicamide prior to sedation to effect timely maximal dilation. Culture specimens and IOPs were not evaluated in these four animals. Indirect ophthalmoscopy was performed on 7/8 eyes of these four beavers. Results Conjunctival specimens from all eyes cultured positively for one or more isolates of aerobic bacteria. The most common isolate was Micrococcus spp. (five beavers; 9/20 eyes). Other isolates included a Gram‐positive coccobacilli‐like organism (four beavers; 7/20 eyes), Aeromonas hydrophila (three beavers; 4/20 eyes), Staphylococcus spp. (three beavers; 4/20 eyes), Gram positive bacilli (one beaver; 2/20 eyes), Enterobacter spp. (two beavers; 2/20 eyes), Streptococcus spp. (two beavers; 2/20 eyes), aerobic diphtheroids (one beaver; 1/20 eyes), and Pseudomonas spp. (one beaver; 1/20 eyes). Clostridium sordellii (one beaver; 1/20 eyes) and Peptostreptococcus spp. (one beaver; 1/20 eyes) were the sole anaerobic bacteria isolated. All conjunctival specimens were negative for growth of fungi. Ophthalmic examinations revealed the normal beaver eye and ocular adnexa included dorsal and ventral puncta, a vestigial third eyelid, and a circular pupil. Average palpebral fissure length was 9.36 mm (SD = 1.00) for both eyes. Mean horizontal and vertical corneal diameters of both eyes were 9.05 mm (SD = 0.64) and 8.45 mm (SD = 0.69), respectively. Mean IOP for the right and left eyes were 17.11 mmHg (SD = 6.39) and 18.79 mmHg (SD = 5.63), respectively. Indirect ophthalmoscopic examinations revealed normal anangiotic retinas. Conclusions Gram‐positive aerobes were most commonly cultured from the conjunctival sac of normal beavers, with Micrococcus spp. predominating. The overall mean IOP in ketamine‐sedated beavers was 17.95 mmHg. The beaver, an amphibious rodent, has an anangiotic retina.     

Ophthalmic examination findings in a colony of Screech owls (Megascops asio)

Objective To report ophthalmic findings in the Screech owl (Megascops asio). Sample population Twenty‐three, apparently healthy adult captive Screech owls in Maryland. Procedures OU of all owls underwent complete ophthalmic examination. One randomly assigned eye of each bird was measured by phenol red thread tear test (PRT), and the other eye by Schirmer tear test (STT). TonoVet^® rebound tonometry and TonoPen‐XL^® applanation tonometry were performed in each eye to measure IOP. Conjunctival swabs were cultured from one eye of 10 birds, corneal diameter was measured in OU of eight birds, and streak retinoscopy was performed on OU of seven birds. Ten birds were anesthetized, and A‐scan ultrasonography using a 15‐MHz probe was performed to obtain axial intraocular measurements. Results Ophthalmic abnormalities were noted in 24/46 (52%) of eyes. Median STT result was ≤ 2 mm/min, ranging ≤ 2–6 mm/min, and mean ± SD PRT was 15 ± 4.3 mm/15 s. Mean ± SD IOP were 9 ± 1.8 mmHg TonoVet^®‐P, 14 ± 2.4 mmHg TonoVet^®‐D, and 11 ± 1.9 mmHg TonoPen‐XL^®. Coagulase negative staphylococcal organisms were cultured from all conjunctival swabs. Mean ± SD corneal dimensions were 14.5 ± 0.5 mm vertically and 15.25 ± 0.5 mm horizontally. All refracted birds were within one diopter of emmetropia. Mean ± SD axial distance from the cornea to the anterior lens capsule was 4.03 ± 0.3 mm, from cornea to the posterior lens capsule was 10.8 ± 0.5 mm, and from cornea to sclera was 20.33 ± 0.6 mm. Conclusions This study reports ophthalmic examination findings in Screech owls, and provide means and ranges for various ocular measurements. This is the first report of rebound tonometry and PRT in owls.     

Intraocular pressure and Schirmer tear test results in clinically normal Long-Eared Hedgehogs (Hemiechinus auritus): reference values

Objective The present study was undertaken to establish reference values for Schirmer tear test (STT) and intraocular pressure (IOP) in the long‐eared hedgehog (Hemiechinus auritus). Animals Fourteen healthy long‐eared hedgehogs (H. auritus) of either sex were studied. Procedures The hedgehogs were individually immobilized with an intramuscular injection of combined Ketamine (20 mg/kg) and Diazepam (0.5 mg/kg), and each animal underwent ophthalmic examinations including: STT, tonometry, biomicroscopy, and indirect ophthalmoscopy. Results No significant effects of animal gender, weight, side (right vs. left eye) were found in this study. Mean (SD) STT values for all eyes (n = 28) were 1.7 ± 1.2 mm/1 min with a range of 0–4 mm/1 min. Mean STT in male animals was 2.2 ± 1.2. Mean STT in female Hedgehogs was 1.3 ± 1.1. Mean (SD) IOP values by applanation tonometry were 20.1 ± 4.0 mmHg (range 11.5–26.5 mmHg). Mean (SD) IOP values by applanation tonometry were 18.2 ± 4.0 and 22.0 ± 3.2 mmHg for males and females, respectively. Conclusions This study reports STT and IOP findings in long‐eared hedgehogs (H. auritus).     

Tear production in normal juvenile dogs

Objective To establish a baseline range or average for tear production in normal juvenile dogs and evaluate the effects of age, weight, and gender on Schirmer tear test (STT) in juvenile dogs. Materials and methods Healthy puppies of various breeds <6 months of age. STT1 and STT2 were performed in both eyes of each subject. Statistical analysis was performed using a backwards stepwise regression model with repeated measures. Using continuous variables of STT1 and STT2 as the dependent variables separately, the independent variables were age (days), eye (left or right), gender (male or female), ocular disease processes in eyes or not, and weight (kg). Results Eighty‐six eyes from 27 males and 16 females were included in this study. Ages ranged from 25 to 133 (mean ± SEM: 61.74 ± 24.15) days and weights ranged from 0.88 to 8.86 (3.27 ± 2.22) kg. STT1 results ranged from 0 to 26 (15.76 ± 5.79) mm/min. STT2 results ranged from 0 to 24 (8.79 ± 5.01) mm/min. Age, weight, and gender significantly affected STT1 results. Weight and gender significantly affected STT2 results. STT1 values increased by 0.15 mm/min for each 1 day increase in age and by 0.84 mm/min for each 1 kg increase in body weight. STT2 values increased by 0.57 mm/min for each 1 kg increase in body weight. Conclusions Age, weight, and gender significantly affect tear production in normal juvenile dogs. STT1 increases to adult values at approximately 9–10 weeks of age.     

Use of punctal occlusion in the treatment of canine keratoconjunctivitis sicca

Twenty eyes of 10 dogs with keratoconjunctivitis sicca (KCS) were treated by occlusion of the ventral nasolacrimal punctum with a silicone punctal plug in order to increase the volume of the remaining tear lake. Punctal size was measured using a commercially available punctal gauge and the appropriate sized plug was inserted under local anaesthesia. Seven dogs showed an increase in Schirmer tear test I (STT) value. STT values immediately prior to plug placement were 2.3 +/- 1.7 mm/minute. STT values with punctal occlusion were 6.1 +/- 4.1 mm/minute, giving a mean increase of 3.8 +/- 2.7 mm/minute (P<0.001). In 14 eyes of eight dogs, the increase in STT values was accompanied by a clinical improvement in the appearance of the ocular surface. In the three dogs with no increase in STT values, the use of punctal plugs reduced the frequency of artificial tear replacement therapy required to maintain a healthy ocular surface. These results show that use of punctal plugs in dogs with KCS may be appropriate where other lacrimomimetic medications have been unsuccessful.     

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.     

The effect of topical pimecrolimus on keratoconjunctivitis sicca and chronic superficial keratitis in dogs: results from an exploratory study

OBJECTIVE: Pimecrolimus is an ascomycin derivative that interferes selectively with the activation of T cells and mast cells and inhibits the production of inflammatory cytokines. This study evaluated the efficacy of an experimental ophthalmic formulation of pimecrolimus in treating keratoconjunctivitis sicca (KCS) and chronic superficial keratitis (CSK) in dogs. ANIMALS AND PROCEDURES: Eight dogs with KCS and six with CSK were included. The dogs were of various breeds, suffered from chronic conditions, and had been pretreated unsuccessfully. The affected eyes were treated with 1 drop of an experimental, corn oil-based pimecrolimus 1% formulation three times a day. Parameters evaluated included Schirmer tear test (STT), ocular discharge, conjunctival inflammation, corneal inflammatory cell infiltrate and scarring, and comfort level. RESULTS: The effect of pimecrolimus 1% was pronounced (increase in STT values to higher than 4 mm/min, no signs of inflammation) or moderate (increase in STT values of 3-4 mm/min, mild signs of corneal/conjunctival inflammation) in a total of 6/8 animals with KCS. In 4/6 animals with CSK, the effect was either pronounced (total regression of fibrovascular infiltration into the cornea, no corneal scarring) or moderate (distinct regression of pannus, mild corneal scarring). The response to treatment was unsatisfactory in four of 14 animals. CONCLUSION: Results of this exploratory study suggest that topical 1% pimecrolimus may be a new effective treatment for keratoconjunctivitis sicca and chronic superficial keratitis in dogs.     

Results of Schirmer tear test in clinically normal llamas (Lama glama)

Purpose To determine the normal reference range for Schirmer tear test (STT) values in clinically normal llamas (Lama glama) Animals Nine captive llamas (Lama glama) (seven females and two males) were used in this study. Procedure Complete ophthalmic examinations were performed without chemical restraint. STT I values were evaluated in both eyes of all llamas using a commercial STT strip of a single lot number (Schirmer‐Tränentest^®, Germany). STT II value was also measured in both eyes of seven female llamas. Results No statistically significant differences among ages or between right and left eyes were found for any of the results. The mean ± SD STT I of 18 eyes of nine llamas was 17.3 ± 1.1 mm/min (Range 15–19 mm/min). The mean ± SD STT II of 14 eyes of seven llamas was 15.4 ± 1.7 mm/min (Range 12.5–17.5 mm/min). A paired samples t‐test demonstrated that there was a significant difference between the STT I and II values (P = 0.001). Conclusion This study provides novel data for normal reference ranges of STT I and II values in healthy llamas. Results of this study may assist veterinarians in the diagnosis of ocular surface disease and syndromes affecting the tear film in these species.     

Correlation between corneal sensitivity and quantity of reflex tearing in cows,horses, goats,sheep, dogs,cats, rabbits,and guinea pigs

Objective Guinea pigs have a very low threshold of corneal sensitivity and at the same time nearly no reflex tearing compared to dogs, cats, and horses. The question arose whether there is a general correlation between corneal sensitivity and the quantity of reflex tearing. Animals studied Totally 160 animals of 8 different species (20 animals per species) were investigated. Procedures The corneal touch threshold (CTT) was measured with a Cochet–Bonnet esthesiometer. The palpebral fissure length (PFL) was measured with a calliper ruler. The Schirmer tear test (STT) was modified by adapting the width of the STT strip to the PFL of every species. For the STT II, 0.4% oxybuprocaine was applied. Results Corneal touch threshold: Cows (1.67 g/mm²), horses (1.23 g/mm²), sheep (1.13 g/mm²), goats (1.44 g/mm²), dogs (2.16 g/mm²), and cats (1.33 g/mm²) show similar CTT values. In contrast, rabbits (6.21 g/mm²) and guinea pigs (7.75 g/mm²) show a significantly lower CTT. Tear Production Difference STT I ? STT II: Rabbits have the greatest decline in tear production with 38.4%, followed by sheep (33.3%), dogs (31.1%), cats (24.7%), cows (23.7%), horses (18.0%), and goats (14.0%). Guinea pigs have no decline, but a slight increase of ?16.0%. Correlation CTT and STT II ? STT I Difference: Pearson’s correlation coefficient shows a small, but significant correlation. The coefficient of determination can only forecast a value with 7.1% certainty. Conclusions The high variance and low reproducibility of results suggest that the measuring devices are inappropriate to assess the evaluated parameters. Therefore, no assured correlation between the corneal sensitivity and the quantity of reflex tearing could be found.