Features September 2004 Issue

Structure of the Canine Eye

Our new series will tour the dog from head to toe. First stop? The eye.

The dog’s eye is pretty much a garden-variety mammalian eye, with some notable adaptations that have evolved over the millennia. It is a globe with two fluid-filled chambers (anterior and posterior). The chambers are separated by the lens, the structure that helps focus light beams onto the rear part of the eye, the retina. The eye’s outer, clear surface, the cornea, offers protection to the inner eye and helps the lens focus light onto the rear of the eyeball, the retina.

Looking into the healthy dog’s eye, you’ll see a dark center (pupil) surrounded by a colored ring known as the iris, and outside the iris is the white sclera. The iris is some shade of brown in most dogs, but some dogs have one or two blue eyes. Attached to the iris are muscles that function to open or close the lens, letting in more or less light, depending on the available light.

Dogs have a prominent third eyelid (nictitating membrane) located at the bottom of the inner part of the eye, between the lower eyelid and the globe of the eye. The third eyelid is thought to offer protection for the eyeball and to help in removing foreign bodies. Third eyelids are normally concealed beneath the lower eyelids, but one or both may become prominent with certain diseases, for several hours after general anesthetic, and with irritation from a foreign body.

Dogs have upper and lower eyelids, and irritations or scratches may arise when the hairs on these lids project toward the eyeball – a condition either genetic or a result of a wound that scarred the lid. The muscles surrounding the eyeballs (the orbicularis oculi) move the eye’s globe so it can be directed toward what the dog wants to see.

The function of the dog’s eye
While the human has evolved as a diurnal (active in the daytime) species, dogs initially evolved as nocturnal or crepuscular (active at dawn and dusk) predator species. As a result, we humans have great visual acuity, color perception, and depth perception, but we do not see well in the dark.

Dogs, in contrast, have well-developed night vision and their sight is well adapted to detect movement. There is some trade-off between visual acuity (the ability to see detail) and the ability to see in the dark. The dog’s visual acuity has been estimated at six times poorer than an average human; admittedly, this is a bit of a guesstimate (how do you get a dog to read an eye chart?).

One blue and one brown iris – perfectly normal.

Compared to the human eye, the dog has a larger lens and a correspondingly larger corneal surface, enhancing its ability to capture light and thus see in reduced lighting conditions. In addition, behind the dog’s retina is a reflective surface, the tapetum, which further enhances low-light vision. The eerie glow you see when a beam of light hits your dog’s eyes at night is the reflection from the tapetal surface of his eye. The tapetum is also easy to see during a routine eye exam using an ophthalmoscope.

Much like the human retina, the dog’s retina is lined with rods (the sensing cells adapted to work best in low light and used for motion detection) and cones (cells that work best in mid to high levels of light, with the ability to detect color). The proportion of rods to cones is much higher in dogs than humans, thus the enhanced night vision in dogs.

In addition, dogs only have two types of cones (dichromat), whereas humans have three types (trichromat). This expansion of cone-cell types allows the human to see a wider spectrum of color; the dog’s world probably consists of yellows, blues, and grays, while the human color range expands into the reds and greens.

A dog’s lateral eye placement allows better wide-angle vision but hinders depth perception and close-up viewing because there is minimal visual overlap between the two eyes (called binocular convergence). Thus, your dog can easily snag a ball moving sideways but may have trouble catching a ball tossed right at his nose.

Specialized eye exams can detect the focal point of the lens – whether it is right on the retina (normal or emmetropia), in front of (myopia or nearsightedness), or behind it (hyperopia or farsightedness). At one time it was assumed all dogs were myopic, but judging from new information on these evaluations, most dogs are likely very near normal (emmetropic). Some breeds, however, are especially prone to being myopic. (Of the examined dogs, the breeds that had a higher incidence of myopia included German Shepherds, Rottweilers, and Schnauzers.)

As a person ages, his lenses “harden” and may eventually develop cataracts. As the lens hardens, its ability to bend (or “refract”) the incoming light to focus it on the retina diminishes, so the person’s visual acuity is diminished over the years and the person typically becomes myopic. Dogs, too, experience this hardening of the lens (see information on cataracts below), and conventional medicine often recommends surgically removing them. However, recent information indicates that after surgery, without the refractive ability of the lens, dogs become terribly hyperopic. Recent advances have produced intraocular prosthetic lenses that help correct for this loss of focusing ability.

Other ways of seeing
Dogs “see” with much more than their eyes; in fact, in comparison to humans, dogs rely far less on their vision. While the dog’s visual perceptions are relatively fuzzy and less colorful compared to ours, the canine nose and ears provide him with profoundly more sensation than do ours. Dogs may smell us long before they see us, and they can hear sounds that don’t even touch our zone of hearing. (More about these senses/organs in later articles.)

In addition to these differences between species, though, we have to consider that the dog’s (and our) eyes are backed up with a myriad of body senses that add to what they actually see. Animals “see” with their entire bodies, a sense that is augmented in haired areas of the body – the “feeler” whiskers on the snout, for example.

Watch dogs at play and it is quite apparent they have an incredible sense of balance. We know that diminished vision (or dizziness) adversely affects this ability to orient the body to the horizon. The sense of balance is enhanced by the nerve endings on the pads of the feet, the joints, and the nerves throughout the spine. All these send kinesthetic information back to the brain, which the animal then processes into information that gives him the current balance status.

There are even more, often subtle, ways of “seeing” that we know little about. What is it, for example, that a dog “sees” in an individual that makes him growl in distrust? Do some (or all) dogs see auras? How is it that the pineal gland, located deep inside the brain, “sees” nature’s cyclic differences in light patterns to trigger reproductive and sleep patterns?

An alternate look at eyes
We can describe the eye in terms of anatomy and physiology. But there are other ways of understanding the eye, and in terms of natural health, these ways may be even more important than the mechanistic descriptions.

Traditionally, the eye has been seen as the portal to the animal’s spirit or soul, and in all cultures there is an abundance of folklore about the eyes: about the connections between eyes and the gods, the relationship of the eyes and the sun or moon or other natural phenomena, and about the eyes as they signify the well being of the animal and of the species.

Many holistic health practitioners also consider the eyes to be sentinels – expressing on the outside the current inner health status of the animal. A healthy animal has eyes that literally shine – giving off a radiant vitality that speaks of whole-body health. A common comment I get from clients after we’ve taken their dog’s pain away with chiropractic and acupuncture is, “I’m not sure he’s walking a whole lot better, but his eyes have their old gleam back.” And, I’ve had clients say, “Doc, you’ve given me my dog back. I can see his old self in his eyes.”

In contrast, a sick animal often mirrors his illness through his eyes. Obvious symptoms include eye discharges or color changes. Reddened eyes, for example, can indicate any number of inner diseases, and severe liver disease may change the normally white sclera to a yellowish tinge. An animal who is sick oftentimes has eyes that have simply lost their luster, seem to be darker or greyer, and/or have lost their ability to mirror vital energy.

Chinese medicine gives another perspective on the eyes. In Chinese medicine the Liver organ system opens into the eyes, and the state of all the “organs” is reflected in the eyes because the pure Jing Qi (activated source of life) of all the organs “pours through the eyes.”

The general appearance of the eyes is especially important for perceiving the animal’s spirit (its Shen). Lively eyes indicate that the Jing (source of life) is uninjured. Stiff, “wooden,” inflexible eyes show a condition that is considered “deficient.” If the whites of the eyes are red, it is a sign of an excess (or “heat”) condition, caused by either “external influences” or an “excess of heat” from an organ, usually the liver.

One sore, infected eye, with a pus-filled exudate. Take this dog right to the vet.

Additionally, some methods use the eyes specifically as an aid to diagnosis. Iridology, for example, claims to be able to diagnose diseases by observing the iris. According to this method, areas of the iris are correlated to organs and areas of the body. When there is a disease within the body, it will be reflected as a change in color or shape in the corresponding area of the iris.

Finally, the time comes at the end of an animal’s life when all vitality seems to be drained, when the eyes seem to be emptied of nearly all of their normal energetics. It’s as if the eyes are telling us it is now time to go on to another life – and veterinarians I know use this eye-sensitive way to help clients decide when it’s time for euthanasia.

Natural care of eyes
You can care for your dog’s eyes naturally. As with any organ system, preventing diseases is always much easier than trying to cure them after the fact.

Exercise and the eyes. Whole-body exercise is a prime component of any program of natural eye care. The eye’s structures are extremely sensitive to oxidative stress and to other toxins. Exercise is our first line of defense and perhaps our most natural antioxidant, helping move oxygen through all the eye’s structures and helping eliminate a buildup of toxins.

For healthy body, mind, spirit, and eyes, walk with your dog for at least 20 minutes a day, and (if your vet has checked him out as basically healthy) occasionally give him some anaerobic exercise by tossing the ball or letting him take a good swim.

Food for the eyes. Nutrition is equally important as exercise, and there are some general eye-care nutrients as well as some that have specific healing qualities for eyes.

Good food for the eyes includes a healthy dose of antioxidants such as vitamins B, C, and E; beta-carotene (and other carotenes such as lutein); co-enzyme Q10; and alpha-lipoic acid. Antioxidants are abundant in green leafy vegetables and other highly colored foods such corn, squash, and egg yolks, and many herbs (including the common culinary ones) are high in antioxidant activity. Zinc, selenium, and magnesium are also important “eye nutrients.” Water is a critical eye nutrient because the membranes of the eye are susceptible to drying when the animal is dehydrated.

Lutein and alpha-lipoic acid have been mentioned in recent human medicine literature as being especially beneficial for eyes, with the usual caveat that results are still preliminary.

Immune system care. Many holistic practitioners feel there is a connection between many (if not all) chronic eye conditions and an imbalanced immune system. In addition to the antioxidants mentioned above, herbs such as echinacea (Echinacea spp.) and Siberian ginseng (Eleutherococcus senticosus) can enhance and rebalance the immune system.

To improve eye conditions, try to avoid anything that compromises the immune system: excess stress; food additives such as synthetic preservatives and artificial flavors and colorings; environmental toxins such as pesticides and herbicides; and the excess use of vaccines.

Since the liver is a major detoxifying organ and (according to Chinese medicine) directly connected to the eyes, it is important to keep it healthy. Nutrients such as the B-vitamins, choline, and inositol enhance liver function. Herbs that are beneficial to the liver include milk thistle (Silybum marianum), turmeric (Curcuma domestica), and dandelion root (Taraxacum officinale).

Practitioners of Chinese medicine believe that anger and depression adversely affect the liver and these emotions also stress the immune system. If a dog is angry (for constantly being left home alone, for example) or depressed (possibly from the recent loss of one of his companions), consider flower essences or aromatherapy for their remedial effects on the emotions.

Eye massage. One way to ease eye tensions and to improve circulation to the eye is to give your dog a massage. Use your fingertips to make a circular motion that begins at the corner of the eye and moves clockwise around the bony structures surrounding the eye. Let your fingers gently dip into tissues surrounding the eye; located here is the Orbicularis oculi, the muscle mass responsible for rotating and turning the eyes.

Concentrate on the corners of the eye (both lateral and medial). Do this circular massage several times, first clockwise, then counter-clockwise – as long as your dog enjoys it. Then, gently lay your fingers over the eye and very gently add pressure to the eyelid. (Practice on yourself first to see how much pressure is comfortable.) This very simple massage not only is relaxing and rejuvenating to the eyes, it stimulates several key acupuncture points.

A continuation of the eye massage is to massage areas that contain key eye-related acupuncture points and “trigger points” (areas that are sore when the associated organ is affected). Give your dog a general neck massage along the sides (from the mastoid bone to the sternum) and upper part of the dog’s neck (from the base of the skull to the shoulders); massage deeply around the upper shoulders; and also massage along the muscles where the two jaw bones attach.

Holistic medicines and the eye
As a general rule holistic medicines function extremely well for treating chronic ocular problems, and western medicines may be more appropriate for some of the acute or traumatic conditions.

Cataracts are an example of a condition that typically arises slowly and gradually, over time. Preventing their occurrence with holistic methods (nutrition, herbs, and food supplements) is the best course of action. Once they have developed, western medicine might recommend cataract surgery to remove them. But I personally would use this only as a last resort, considering holistic options first, whenever possible.

On the other hand, if a dog has just been kicked in the eye by a mule and there is immediate swelling and perhaps blood, I’d make a quick trip to the best eye specialist I could find.

A red eye (conjunctivitis) might be an example of a case that is in the gray zone – whether you should consider western medicine, alternative therapies, or consult a veterinary ophthalmologist will depend on the severity of the case, whether it came about acutely or over time, and your own gut feelings for what you feel would be the right way to proceed.

Conventional Western medicine tends to be fast-acting, but typically addresses conditions only at their surface, palliating symptoms with little concern for the underlying cause, which results in a lack of deep healing. Alternative medicines are, as a general rule, slower to act, perhaps because they tend to delve deeper into the cause of the condition. While adverse side effects can occur with any medicine (or almost any substance, for that matter), they occur far less frequently with alternative medicines. Some of us feel that many of the conventional Western medical methods actually create long-term, chronic problems.

Acupuncture has been successfully used to treat many eye conditions. Keratitis, chronic conjunctivitis, and all sorts of eye irritations typically respond favorably to acupuncture, and cataracts or even blindness may respond.

This dog was already blind when rescued by her owner. The eye on the left has cataracts; the eye on the right has detached retina.

A typical acupuncture approach to eye conditions might seem strange to a western-trained practitioner. Chinese medicine visualizes the eyes as connected to the Liver (an “organ system” concept that correlates somewhat, but not entirely, to Western medicine’s understanding of the form and function of the liver).

An acupuncturist might therefore diagnose a condition of conjunctivitis as an example of excess/heat of the Liver, and her needling points would be positioned to bring the Liver back into balance and to further bring the whole body back to a state of harmony of Yin and Yang.

Many healing herbs can be applied topically to the eyes and have proved to be successful for treating all kinds of eye conditions. In addition, herbs can be taken internally for their nutrient value – vitamins, minerals, and antioxidants.

Some herbs, notably bilberry (Vaccinium myrtillus) and eyebright (Euphrasia officinalis) are reputed to have a direct effect on the eyes when taken internally. In addition, many herbs enhance liver function and the immune system, the other important components of overall eye care. [Editor’s note: Dr. Kidd’s book, Dr. Kidd’s Guide to Herbal Dog Care, contains much more information on herbs for dogs. See "Resources" for purchasing information.]

At first glance it may seem that chiropractic adjustments would have no effect on the eyes. But the eyes are, after all, connected directly to the brain. Trigger points along the neck muscles may refer to conditions occurring in or around the eyes, and these trigger points may be due to underlying misalignments of vertebrae. So, in addition to massage, chiropractic adjustments may alleviate these trigger points and concurrently help eye conditions.

Common eye diseases, diagnoses, and natural treatments Following are brief discussions of the diagnoses and treatment protocol a holistic practitioner might use for the most common eye diseases of dogs: eye irritants, conjunctivitis and keratitis, cataracts, and dry eyes. Remember that every case presents its individual problems and solutions, and that there is no one-treatment/dosage-fits-all in holistic medicine. Remember too that holistic medicine (at least as I define it) includes the possibility that we may use some of conventional Western medicine’s methods as well those normally considered alternative.

All the treatments listed below assume that, along with these treatments, we will also be doing some or all of the above mentioned therapies: periodic cleansing and soothing eye washes; nutrient and herbal support; massage; exercise; enhancing the immune system and avoiding anything that might diminish its abilities; and giving attention to the liver as it is associated with the eyes.

Finally, I absolutely recommend that you immediately see a veterinarian (who may want to refer you to a Board Certified Ophthalmologist) whenever the eye symptoms have a sudden onset; you see blood, either around the eye or within the globe itself; the eyeball itself appears swollen or the eyelids are severely swollen; and the pain or irritation is driving your dog nuts.

Eye irritations. Intruders into the eye can be almost anything from dust particles, pollen, irritating chemicals (pesticides, herbicides, etc.), and smoke to larger splinters, thorns, or plant awns (such as foxtails). A common, temporary intruder, especially for inquisitive puppies, is a cat’s claw. The extent of the damage caused by these intruders depends on whether they have scratched or ulcerated the cornea and on the amount of pain or irritation they produce.

Signs that your dog has acquired an eye irritant include tearing and redness; whining, scratching at the eye(s), rubbing on the floor; swelling of tissues surrounding the eye(s); prominence of the third eyelid(s); and if the condition has been ongoing for a while, a mucoid (gunky) or purulent (pus-containing) discharge.

If only one eye is affected, the irritant is likely limited to that eye (think foreign body such as a fox tail here, or irritation from a scratch). If both eyes are affected, it is likely from an environmental irritant, but with bilateral involvement we also have to consider the possibility of generalized disease.

Removal of the irritant is, of course, the first step. For dust particles and mild chemical irritants, the eye wash listed earlier will probably suffice. Larger particles may need to be removed mechanically and this often requires anesthesia. It always surprised me the number of seemingly huge foreign bodies (oftentimes foxtails) I removed from behind the third eyelid when I was managing an emergency clinic in California. These are typically hidden from view and require anesthesia to remove.

If the redness and irritation persist after you’ve washed out the irritant, there may be a scratch on the cornea. Have your vet stain it to be sure, and use the follow-up treatment that is appropriate for the extent of the damage.

Conjunctivitis and keratitis. Conjunctivitis is inflammation of the membrane that lines your dog’s eyelids and the front of the sclera; keratitis is inflammation of the cornea. The presence of either of these diseases may indicate a generalized disease or one limited to the eyes, and their symptoms are much the same as those that occur with irritants (perhaps without the intense pain). Conjunctivitis and/or keratitis can be caused by any number of infectious agents – bacterial, viral, or fungal.

Some herbs have antibiotic activity, and herbal medicines are typically effective against a broad range of potential pathogens. For mild conjunctivitis, a soothing tea with additional antimicrobial activity can be brewed using one or more of the following herbs: chamomile (Matricaria chamomilla), calendula (Calendula officinalis), elder flowers (Sambuscus nigra), or Oregon grape root (Mahonia spp).

“Doggles” can protect eyes; see www.doggles.com or call (866) DOGGLES.

Strain the brew and soak a clean cloth or gauze to be used as a compress over the eye, or put several drops directly into the eye several times a day.

In Chinese medicine the most common cause of conjunctivitis is Liver Heat. Acupuncture can be used to “calm” the heat and restore immune system balance.

Cataracts. A cataract is a spot on the lens (or over the entire lens) that has lost its transparency. When a dog’s pupils appear blue or gray in normal light, he likely has cataracts. (A scar on the cornea – from an old, healed wound, for example – may also appear as a gray or blue spot. Your vet can tell whether you are dealing with an old scar or cataracts.) Cataracts develop gradually, typically over several years.

In humans almost everyone over the age of 65 has some degree of opacity, and after 75, cataracts are common. Cataracts usually occur in both eyes, are painless, and almost never cause total blindness. While they are commonly a factor of old age, cataracts may also be caused (or precipitated) by trauma, chemicals (especially steroids), X-rays, and high blood sugar as observed with diabetes mellitus.

Conventional therapy consists of removing the lens surgically, but cataracts are an example of a condition that may respond very well to alternative therapies.

Nutrition is especially helpful, concentrating on antioxidants: alpha-lipoic acid, Coenzyme Q10, and lutein (the carotenoid that is concentrated in the pupil), have all been mentioned as especially important here. In addition, vitamins A, C, and E are important, as is zinc and the B vitamins. Make sure the dog drinks plenty of water, to prevent the membranes of the eye from dehydration.

Good herbs to add to the diet include eyebright and bilberry, and any others with antioxidant activity. (Almost all the common culinary herbs have significant antioxidant activity, making them a good nutritional supplement for their medicinal quality as well as for their ability to stimulate the aging appetite.)

Acupuncture might be helpful for improving circulation to the head, immune-system function, and to promote healing.

Dry eyes and arthritis. Tears are not just water. They have three separate components: oil (from the Meibomian glands in the eyelids); mucus (from goblet cells deep inside the eyelids); and watery tears (from the lachrymal glands located in the conjunctiva of the eyelid). Tears wash away intruders and lubricate the eyes and lids.

Dry eyes can be caused by eye diseases or systemic conditions, and evidence is mounting that common causes are related to other chronic and immune-mediated medical conditions such as arthritis, diabetes, and systemic lupus. Many medications, such as antihistamines, antidepressants, diuretics, gastrointestinal medications, and cold remedies, can also cause dry eyes.

Symptoms of dry eyes – the result of corneal drying and possible ulcerations – include redness, pain and itching, and even excessive tearing at times. Diagnosis of dry eyes is confirmed by a test called a Shirmer test which uses a test strip of paper placed on the lower lid to measure the production of tears.

Conventional treatment consists of restoring the tear film with artificial tears. There are three types of artificial tears: preserved (with benzalkonium chloride or EDTA), transiently preserved, and nonpreserved. Preserved tears, while perhaps the safest in avoiding potential contamination, can be irritating to some patients. Transiently preserved tears are more cost-effective while being minimally irritating. Nonpreserved tears are meant for single-dose administration and are the most expensive.

Similasan eyedrops, a homeopathic herbal preparation containing apis, euphrasia, and sabadilla, can be substituted for the other artificial tear preparations.

Nutritional support is especially important for treating dry eyes. Antioxidants are very helpful. Be sure to include vitamin A or other carotenoids (those with a vitamin A deficiency often have dry eyes, skin, and hair); B vitamins; zinc; magnesium (dilates the small blood vessels that bring blood to the tear glands); and calcium. Again, make sure the dog drinks plenty of water.

Since there is good evidence of a connection between dry eye and arthritis, when treating dry eye, many holistic practitioners add supplemental therapies for arthritis from the outset, such as glucosamine and chondroitin sulfate.

 

-Dr. Randy Kidd earned his DVM degree from Ohio State University and his Ph.D. in Pathology/Clinical Pathology from Kansas State University. A past president of the American Holistic Veterinary Medical Association, he’s author of Dr. Kidd’s Guide to Herbal Dog Care and Dr. Kidd’s Guide to Herbal Cat Care (see "Rersources").

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