Dry Eyes KCS In Bulldogs And French Bulldogs

By: Dr. Roy Kraemer |
DVM, Bulldog Specialist Veterinarian

Dry Eye KCS in Bulldogs and French Bulldogs is a very common ophthalmic condition associated with the breed. It is characterized by chronic inflammation of the ocular surface, the conjunctiva, cornea, and sclera.

Dry Eye KCS in Bulldogs and French Bulldogs

Bulldog Dry Eyes KCS WHAT IS IT

KCS is short for “Keratoconjunctivitis Sicca” which is Latin for dryness of the membrane that covers the surface (white part) of your bulldog’s eyes.

KCS is more often seen in adult bulldogs and less commonly found in French Bulldog puppies and English Bulldog puppies 

Bulldog dry eye often affects both eyes, but could be diagnosed initially in just one eye, and only later in the other eye.

Dry Eyes KCS in Bulldogs / THE TEAR FILM

Your bulldog’s tear film is composed of three layers.

  1. MUCIN: is the inner part that helps stick the tears to the cornea.
  2. LIPID: is the outer oily layer that helps prevent the evaporation of the tear.
  3. AQUEOUS: This is the middle, watery part you all associate with tears. It contains vital compounds and is critical for the lubrication of the cornea.

Dry Eyes Bulldogs KCS / THE CAUSE:


The dryness is due to decreased tear production, and in bulldogs and French bulldogs, it is most often an immune-mediated disease (autoimmune). 

Inadequate tear production and dryness of the eyes can lead to painful corneal inflammation, scarring, ulcers and vision impairment.


  • TRAUMA: Trauma to the bulldog’s eye, skull, or orbit.
  • Neurological: injury to your bulldog’s cranial nerve 7 (Facial Nerve Paralysis) or CN5 (Trigeminal nerve).
  • DRUG INDUCED:  (Sulfa Drugs, see “tips & warnings”).
  • HORMONAL DISEASE: Such as Bulldog Hypothyroidism.
  • CHERRY EYE REMOVAL:  The cherry eye must be preserved when repaired due to prolapse.


Up to 30% of the aqueous part is produced in the nicotinic member, better known as the bulldog cherry eye.

Therefore, the surgeon operating on it must preserve the cherry (nicotinic membrane with gland).

Removing the cherry could lead to a bully dry eye or exasperate it.

Dry Eyes KCS in Bulldogs and French Bulldogs PRESENTATION: 

Most bulldogs with KCS present with a history of chronic, recurrent, nonspecific keratoconjunctivitis.

Low tear production leads to corneal dehydration and hypoxia.

Here is a list of the most common findings noted with bully dry eye:

  • DISCHARGE: Mucoid chronic d/c
  • REDNESS: Red injected conjunctiva and sclera
  • FOGGY CORENA: Discolored, pigmented, vascular, and fibrotic cornea (should be clear)
  • INFECTION: KCS can break down the corneal protective barriers, thus predisposing your bulldog to secondary bacterial conjunctivitis.
  • BLINDNESS: Partial or complete loss of vision.

Dry Eye Bulldogs KCS DIAGNOSIS

A simple tear production “litmus test” named “Schiemer Tear Test” will be conducted to help measure your bulldog’s quantitive tear production.

Dry Eye KCS in Bulldogs and French Bulldogs Tear Test


AQUEOUS / QUANTITATIVE: The aqueous part is quantitative and is the only tear film part tested.

MUCIN / QUALITATIVE: The mucin and lipid parts are qualitative and are not measured by that test.


In the early stage of your bulldog’s dry eye disease, mucin, and lipid production is low, but aqueous production could still be normal.

Because the tear test only measures the aqueous part, it is often interpreted erroneously as “normal,” despite clinical findings consistent with bulldog-KCS.

An experienced bully veterinarian is likely to factor all that into his or her diagnosis and initiate appropriate bully dry eye treatment.


Is a simple quick tear production test. The test includes a narrow slip of paper that is placed in the eye for 1 minute.

The tears will color the paper blue, the bluer the better.

  • Normal Bulldog: 20 mm or more wetting/minute
  • Early Bulldog KCS: 15-19 mm wetting/minute
  • Mild Bulldog KCS: 11-14 mm wetting/minute
  • Moderate Bulldog: KCS: 6-10 mm wetting/minute
  • Severe Bulldog: KCS: <5 mm wetting/minute


To detect if there is an active corneal ulcer, your vet will conduct a fluorescein staining of your bully’s cornea and then examine the stained area under a UV light source in a dark room.


While ophthalmic steroids help to reduce inflammation, they can also exasperate an active corneal ulcer.

Dry eye topical ophthalmic medication containing steroids should only be used after staining the cornea.

Dry Eyes in Bulldogs KCS TEAR TEST

Dry Eyes Bulldogs KCS PREVENT & TREAT

REMOVE MUCUS: First, clean and remove all the debris and mucus from the eyes. A simple, inexpensive OTC hypotonic eyewash will do (sterile water).

IMMUNE SUPPRESSANTS: Dry eye medications are based on immune suppressants topical ophthalmic ointments or drops, like Cyclosporine and Tacrolimus.

ANTI-INFLAMMATORY: such as ophthalmic hydrocortisone or dexamethasone.

ANTIBIOTICS: Sometimes short-term topical ophthalmic antibiotics are needed.

LUBRICANTS: I like ones that include hydronic acid. They are often adequate for early-stage Bulldog KCS.

Bulldog Dry Eye KCS Pain Relief

Dr. Kraemer’s Bulldog & French Bulldog Dry Eye RULE OF THUMB

To prevent the deterioration of your bulldog’s cornea, avoid vision loss, and manage discomfort, treatment must be applied every day for the rest of your bulldog’s life.

I recommend testing your bully’s tear production any time your bully has an eye problem, particularly a corneal one.

Dry Eyes in Bulldogs and French Bulldogs KCS TIPS & WARNINGS

Dr. Kraemer’s Bulldog Dry Eye KCS TIPS:


OTC lubricants and irrigating eye drops are allowed, but not as a replacement for the ophthalmic Rx listed above. My preference is those with hyaluronic acid.

Bulldog KCS Tip #2 WASTE: Some of the prescription dry eye ophthalmic drops are expensive, so don’t be wasteful. One drop on the eye is enough.

Ointments are pressurized and hard to control, I prefer the drop form.

Bulldog KCS Tip #3 RINSE:

To optimize the Rx impact, always clean the mucus and debris from the eyes with sterile water and/or a clean wipe.

Bulldog Dry Eye Tip #4 CHERRY EYE:

I recommend surgically fixing your bulldog puppy’s cherry eye.

Leaving your bulldog’s “cherry eye” and postponing surgical correction can cause chronic corneal irritation of your bulldog puppy’s eyes.  To learn more, click here.


immune-mediated KCS should be your presumed underlining cause.

Dr. Kraemer’s Bulldog Dry Eye KCS WARNINGS:

KCS Warning #1 CHERRY EYE:

Surgically removing your bulldog puppy’s “cherry eye can cause bulldog dry eyes (KCS) due to its aqueous contribution to your bulldog’s tear film. To learn more click here.

Bulldog Dry Eye Warning #2 STEROIDS:

Ophthalmic steroids should not be used on an active corneal ulcer because they can impede healing. Always check with your veterinarian before using one.

Dry Eye Warning #3 COMMITMENT:

Failing to treat your bulldog’s dry eye will likely lead to continuous corneal deterioration, pain, infection, and impaired or lost vision.

Treating bulldog dry eye (KCS) must be done DAILY for the remainder of your bully’s LIFE.

Bulldog KCS Warning #4 SULFA DRUGS:

Sulfa drugs can cause dry eyes (KCS). They should be prescribed cautiously or avoided. When prescribed, tear production should be checked prior to starting and again in 5 days.

KCS Warning #5 CAR RIDES:

Do not let your bulldog puppy stick his or her head out of your car windows while driving. When doing so, make sure to place protective goggles over the eyes.


Antihistamines like Benadryl can reduce tear production.

Bulldog Dry Eye Warning # 7 VISINE:

I don’t recommend using Visine tear lubricants on your bulldog because it can cause vasoconstriction of blood vessels and eventually worsen your bulldog’s KCS dry eye condition.

French Bulldogs KCS Warning # 8 OPPOSITE EYE:

If your bulldog has one dry eye, the other one should be monitored. There is a high chance that over time it will also suffer from tear deficiency.

Bulldog KCS Warning # 9 CORNEAL ULCER:

Cornea staining should be done in addition to the tear production test (STT) to help rule out corneal ulcers.


Unfortunately, some veterinarians fail to diagnose the true underlying problem, erroneously misdiagnosing and treating your bulldog’s dry eye as bacterial conjunctivitis.   The error could lead to a false sense of security, and a delay in the needed treatment. The combined errors could end in blindness.

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The information provided on this platform is for general informational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your veterinarian regarding any medical condition. It's important to always consider professional medical advice promptly and not to delay seeking it based on information you've read on this platform. Any reliance on the information provided here is entirely at your discretion.

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