TREATMENT OF PIGMENTAL KERATITIS.
An agent capable of completely reversing pigment keratitis does not exist. After the pigment covers the cornea, it becomes difficult to eliminate. As a prophylaxis and to reduce the amount of pigment, eye drops such as cyclosporin A (CSA) and tacrolimus should be used. Both of these drugs are immunomodulators, that is, they affect the response of the immune system to what is happening in the eye. How these drugs can affect corneal pigmentation is still unknown. Acceptance of drugs can continue throughout life. If the reception is stopped, then it is likely that the pigmentation will intensify. An additional advantage of these drugs is that they fight dry eyes (keratoconjunctivitis). Some elderly dogs have dry eye syndrome, which worsens the course of pigment keratitis. These drugs help with both diseases.
With pigment keratitis, other drugs can also be prescribed, including steroids, such as dexamethasone or prednisone. Steroids suppress the immune system, but they do not like cyclosporin or tacrolimus. Since steroids actively suppress the immune system, they are often associated with the appearance of an eye infection. Steroids may be given by injection into the conjunctiva of the eye.
Surgical pigment removal is not long-term effective as the stain returns quickly. Surgery of the eyelid can slow down the development of keratitis, due to which the inner corner of the lower eyelid ceases to cover the surface of the eye. To do this, surgical techniques such as medial cantoplasty, dissection of the medial cantal ligament, and Hotz-Celsus intervention are used.