Tear Staining: Your Questions Answered
I have a two year old Mal-shi-poo and he has terrible red staining from the inside corners of his eyes. It seems to bother (itch??) him as he rubs at it quite a bit. Do you have any suggestions for a "home remedy" or prescription solution? Thank You. - Beverly Peterson, Gilbert, MN
The condition that you are describing is called epiphora which occurs whenever there is an overflow of tears onto the face. It can be caused by either excessive tear production, insufficient tear drainage, or a combination of both. Epiphora can be acute or chronic, most likely everyone has experienced at some point the tearing and irritation that results whenever something gets into our eyes. Tears are the eye’s natural response to an irritant and are an attempt to flush away whatever is causing that irritation. When epiphora becomes chronic, the constant moisture around the eyes results in skin irritation and creates a fertile breeding ground for bacteria and yeast which is causing your Mal-shi-poo to rub his eyes. Over time we see red staining around the eyes that is due to accumulation of a pigment called porphyrin which is found in tears.
Your first step should be to see your regular veterinarian or a veterinary ophthalmologist. They will examine the eye to make sure there is no foreign body is present. Some other things they will look for are distichiasis or ectopic cilium that is when an eyelash grows abnormally in such a way it ends up facing the cornea instead of facing away. This is common in some breeds including shih-tzus and poodles. They will check for other causes of excess tear production such as conjunctivitis, uveitis and glaucoma. Sometimes epiphora is not a result of excessive tear production but is a problem with tear drainage. Normally tears exit the eye through small holes called puncta, which leads to a duct called the nasolacrimal duct which empties out into the nose. This is why we have to blow our noses whenever we have a good cry. Sometimes this duct can be blocked with debris such as grass awns, rhinitis or sinusitis, which results in soft tissue swelling around the duct leading to occlusion. Some breeds such as poodles are predisposed to imperforate puncta which is when the nasolacrimal duct does not develop right resulting in chronic epiphora due to lack of drainage. Your veterinarian may use a fluoresecein stain to check for corneal ulcerations and to check the patency of the nasolacrimal duct. In a normal dog, fluorescein stain will appear around the nose a few minutes after applying the stain to the eye.
Treatment will vary depending on the underlying cause of epiphora. Sometimes simply flushing out the eyes will do the trick if there is a foreign body present causing the irritation or blocking the nasolacrimal duct. If an abnormal eyelash is causing the problem then it can be removed by cryosurgery or electrolysis. If the nasolacrimal duct is blocked by swelling from glaucoma, sinusitis or rhinitis then treatment is focused on getting the primary condition under control and usually when the swelling resolves patency of the nasolacrimal duct is restored. In the case of imperforate puncta, surgery may be necessary to open the puncta or to create an opening into the nasal cavity for tears to drain via dacryocystorhinotomy.
In the meantime you can increase your dog’s comfort level by keeping the fur around the eyes trimmed and gently cleaning the corners of the eyes with a paper towel moistened with warm water. If he is intent on pawing at the eyes then use an Elizabethan collar to prevent any self-inflicted damage to the eyes until you can get him to your veterinarian. There are a variety of tear staining products available but I do not recommend using them until you check with your veterinarian first since they tend to mask disease and do not address the underlying cause of whatever may be causing your dog’s epiphora.