Dear Doctor: Over-the-Counter Meds as Opposed to Prescription?


Q. We have a shih tzu who has been diagnosed with dry eye in both eyes. Our veterinarian prescribed OPH Optimmune Ophthalmic Ointment, but the results are mixed at best, and at $65 per small tube we find it financially difficult to keep up a daily application routine. We had a suggestion from an ophthalmologist who treats people that we look into over-the-counter eye drops that contain oil, but he said we might have to try several before finding one that was right for our dog.

We went through several OTC eye drop preparations. Most worked somewhat, but we finally hit on Systane Gel Drops Lubricant Eye Gel Anytime Protection. We apply this preparation twice daily (one drop each eye) and are getting remarkable results. Our dog’s eyes are looking very normal for the first time in his eight years. Best of all, the price for a bottle that lasts about three weeks of twice daily applications is only $13.49. Do you believe that we have hit on a good alternative to Optimmune?

Frederick Sheeman

Canal Winchester, Ohio

Dear Mr. Sheeman,

A. Dry eye is very common in shih tzus. Sometimes it’s a quantitative issue, meaning the dog does not produce enough tears. Sometimes it’s qualitative — tear production is fine, but the tears evaporate too quickly. Medications like tacrolimus and cyclosporine are highly successful in treating it. Optimmune contains cyclosporine, but in a very low concentration. “Stronger concentrations often need to be compounded” to get it to work, says Nancy Bromberg, VMD, a veterinary ophthalmologist who practices in the Washington, DC, area.

Another option for some dogs is artificial tear supplements. They contain various preservatives, and in some case these preservatives can cause irritation, and you have to find one that works for your own particular dog. Thus, it makes sense that you had to try several before hitting on one that worked. The fact that your pet has gotten better on over-the-counter tears may mean she has a qualitative tear deficit rather than a quantitative one.


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