Keratoconjunctivitis sicca

Hi, over the last 2 months my 6 year old American Cocker Spaniel has developed inflammation of the lower eyelid with eye discharge and a glassy/cloudy effect over the eye itself. I initially visited my vet who confirmed no trauma to the eye and prescribed Maxitrol eye drops. As the eye became more inflamed and more cloudy I went back to the vet/eye specialist 2 weeks ago who examined and performed a schirmer tear test. He diagnosed Keratoconjunctivitis sicca and prescribed optimmune (cylosporin) eye drops for long term use. I am currently applying these drops twice daily and Chloramphenicol 1% ointment twice daily. Her eye only appears to be getting worse with more clouding, inflammation and blinking. I am planning to go back to the vets again this week and wonder if this is necessary and if there is anything else my vet can actually do? I am also wondering if anyone can advise if I should expect her eye to be improving or should be accepting that the eye will gradually deteriorate? Many thanks Harry

Dear Harry  I'm afraid that I might be a disappointment; if your dog has already seen a first opinion vet in the flesh, followed by a qualified eye specialist, then I suspect that I might be unwise to think that I have technical knowledge to add to their combined expertise.  I am, after all, working from just your online description. However, what I do know is that if the eye is getting worse, then now is the time to call your vet or specialist back, because eyes do deteriorate very quickly and eye changes are generally to be treated as emergencies. Emergency or not, the vets have hopefully talked you through what to expect in response to treatment, and if you don't feel that this is happening, either reassurance or a change or intensification in the treatment plan is required. Your vet may by now have in their possession a referral letter from the specialist, which - even for obscure problems - tends to explain how to monitor the situation and at what point interventions may be required. Good questions include, what is causing the blinking?  Is my dog in pain?  What is the likely outcome and to what extent will treatment help? Because eyes do deteriorate very fast, it's definitely worth pursuing. Please do let us know what happens next.