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Chronic Superficial Keratitis (Pannus)

Sara Calvarese, DVM
Eye Care for Animals

Chronic superficial keratitis (CSK) is a bilateral inflammatory condition of the canine cornea. Although the condition can occur in any breed, German Shepherds and Greyhounds are overrepresented. The condition usually begins at the temporal limbus with local conjunctival and corneal vascularization. As the blood vessels advance into the cornea, limbal pigment migrates axially as well. Plasma cell infiltration of the third eyelid is sometimes also seen in German Shepherds. If left untreated, CSK can cause severe corneal scarring, pigmentation and vascularization that may lead to blindness. Histopathology of affected corneas reveals increased numbers of CD4+ lymphocytes, suggesting that CSK may be an immune-mediated disease. Animals that live at higher elevations, in areas of increased ultraviolet light, and those that are affected at a younger age are often more severely affected.

Treatment with topical steroids alone has been the mainstay of treatment for many years, but the addition of topical cyclosporine can improve control of the condition. Subconjunctival steroids can also be of benefit in controlling more severe cases. Cases that are not responsive to medical therapy may necessitate superficial keratectomy or treatment with beta radiation. Always inform owners that this disease will require lifelong treatment, and suggest consultation with an ophthalmologist in severe cases or in cases that are poorly responsive to medical therapy.


Early pannus, note temporal corneal neovascularization.	Advanced pannus, note corneal pigmentation, neovascularization and granulation tissue.

De-pigmentation and plasmoma development on the third-eyelid in association with pannus.	Chronic corneal pigmentation in a controlled case of pannus.

reprinted with kind permission from Julie Gamarano
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The above information is simply informational. It's intent is not to replace the advice of a veterinarian nor to assist you in making a diagnosis of your pet. Please consult with your own veterinarian for confirmation of any diagnosis. Your pets life may depend on it.