Pannus in Dogs (Chronic Superficial Keratitis)

Pannus in Dogs: Symptoms, Treatment & Prevention Guide (Vet Approved, 2025)

What is Pannus in Dogs? 

Pannus in dogs is a progressive eye disease that affects the cornea and third eyelid, potentially leading to blindness if left untreated. "...also known as chronic superficial keratitis (American College of Veterinary Ophthalmologists), this immune-mediated condition..." causes a grayish-pink film to develop over the dog's eye as blood vessels and scar tissue invade the cornea.

This dog eye disease typically affects both eyes simultaneously, though one eye may appear more severely affected than the other. The condition is most commonly seen in German Shepherds, representing up to 90% of all cases, but can occur in any dog breed.

Key Facts About Pannus:

• Scientific name: Chronic Superficial Keratitis (CSK)
• Primary affected breeds: German Shepherds, Belgian Tervurens, Border Collies
• Age of onset: Typically 5-8 years old
• Progression: Slow but progressive without treatment
• Prognosis: Excellent with proper treatment and management

Understanding Chronic Superficial Keratitis

Chronic superficial keratitis is the medical term for pannus, describing the ongoing inflammatory process affecting the dog's corneal surface. This immune-mediated condition involves the dog's immune system mistakenly attacking healthy corneal tissue, leading to characteristic changes in the eye's appearance.

The Science Behind Pannus

The disease process begins when inflammatory cells from the immune system settle onto the cornea, forming small raised lesions alongside blood vessels. This change usually starts in the temporal (outer) or ventral (lower) quadrant of the cornea and progressively spreads.

What happens during pannus progression:

1. Initial stage: Small pink or red raised lesions appear on the corneal surface
2. Progressive stage: Blood vessels grow into the cornea (vascularization)
3. Advanced stage: Brown pigment deposition and corneal haziness develop
4. Severe stage: Significant vision impairment or blindness may occur

German Shepherd Eye Problems: Why This Breed? 

German Shepherd eye problems are well-documented, with pannus being the most common condition affecting this beloved breed. There is likely a genetic component to the cause of chronic superficial keratitis due to its predominance in certain breeds.

High-Risk Dog Breeds for Pannus:

Primary breeds (highest risk):

• German Shepherds - 90% of all pannus cases
• Belgian Tervurens - Closely related to German Shepherds
• Border Collies - Working dogs with similar genetics

Secondary breeds (moderate risk):

• Greyhounds
• Siberian Huskies
• Rhodesian Ridgebacks
• Australian Shepherds
• Labrador Retrievers (mixed breeds)

Why German Shepherds Are Most Affected

Research suggests that German Shepherds have a genetic predisposition that makes their immune systems more likely to develop this autoimmune response. German Shepherd owners should be particularly vigilant about regular eye examinations, especially as their dogs reach middle age.

Pannus Symptoms: Early Warning Signs 

Recognizing pannus symptoms early is crucial for successful treatment and preventing vision loss. Pannus is an eye disease that can result in blindness if it is not treated promptly.

Early Signs of Pannus in German Shepherds

In German Shepherds, pannus often starts with small pink or red spots at the outer corner of the cornea. Owners may notice a slight haze developing, even though the dog shows no pain or irritation. Because this breed is so prone to pannus, any visible change in the eye’s clarity should prompt an immediate vet visit. Catching pannus at Stage 1 gives the best chance for preserving vision.

Early Pannus Symptoms (Stage 1):

• Pink or red raised lesions on the corneal surface
• Lesions typically appear on the outer corner of the eye first
• Non-painful condition - dogs show no signs of discomfort
• Slight haziness beginning to develop on the cornea
• Third eyelid thickening may be noticeable

Progressive Symptoms (Stage 2-3):

• Gray-pink film covering larger areas of the eye
• Increased corneal opacity - the eye becomes cloudier
• Brown pigmentation developing on the cornea
• Excessive tearing and mild redness around the eye
• Both eyes affected, though often asymmetrically

Advanced Symptoms (Stage 4):

• Significant vision impairment
• Dense corneal scarring
• Complete corneal opacity in severe cases
• Behavioral changes due to vision problems

Stage	Symptoms	Eye Appearance	Recommended Treatment
Stage 1	Pink/red lesions, no pain	Slight haze, corner affected	Topical corticosteroids
Stage 2	Gray-pink film spreads	Increased cloudiness	Steroids + Cyclosporine
Stage 3	Pigment deposition	Brown spots, opacity	Aggressive combo therapy
Stage 4	Vision loss	Full corneal opacity	Possible surgery

When to Contact a Veterinary Ophthalmologist

Seek immediate veterinary care if you notice:

• Any pink, red, or brown spots on your dog's cornea
• Cloudiness or haziness in your dog's eyes
• Changes in your dog's vision or behavior
• Your dog is a high-risk breed (especially German Shepherds aged 5+)

Causes of Dog Eye Disease: Understanding Pannus Risk Factors 

While the exact causes of pannus in dogs remain not fully understood, veterinary research has identified several contributing factors that increase a dog's risk of developing this chronic superficial keratitis.

Primary Risk Factors:

1. Genetic Predisposition

• Strong breed correlation, especially German Shepherds
• Inherited immune system abnormalities
• Family history of eye problems

2. Environmental Triggers

• High UV exposure: Dogs living in sunny, high-altitude areas
• Airborne irritants: Dust, pollen, and environmental pollutants
• Altitude factors: Dogs living above 5,000 feet elevation

3. Age-Related Factors

• Most commonly develops in middle-aged dogs (5-8 years)
• Immune system changes with aging
• Cumulative environmental damage over time

Secondary Contributing Factors:

Pre-existing Eye Conditions:

• Entropion (eyelids turned inward)
• Dry eye syndrome (keratoconjunctivitis sicca)
• Previous eye injuries or infections
• Other immune-mediated eye conditions

Lifestyle Factors:

• Outdoor working dogs with increased sun exposure
• Dogs living in desert or mountain environments
• Limited access to regular veterinary eye care

Pannus Treatment Options: What Works Best

Pannus treatment focuses on controlling the immune response and preventing disease progression. Treatment involves using topical corticosteroids (typically prednisolone or dexamethasone) or other immune-modulating drugs such as cyclosporine.

Best Eye Drops for Pannus in Dogs

The most commonly prescribed eye drops for pannus are prednisolone acetate and cyclosporine ointment (Optimmune®). Prednisolone works quickly to reduce inflammation, while cyclosporine is ideal for long-term control with fewer side effects. In advanced cases, veterinarians may recommend tacrolimus. Always follow your vet’s dosage instructions and avoid over-the-counter products unless approved by a veterinary ophthalmologist.

Primary Treatment Medications:

Topical Corticosteroids:

• Prednisolone acetate: Most commonly prescribed first-line treatment
• Dexamethasone: Alternative corticosteroid option
• Application frequency: 2-4 times daily initially, then reduced as controlled
• Benefits: Rapid reduction of inflammation and vascularization

Immunomodulatory Drugs:

• Cyclosporine (Optimmune®): Effective long-term management option
• Tacrolimus: Alternative immunosuppressive medication
• Application frequency: Typically twice daily
• Benefits: Fewer side effects with long-term use

Advanced Treatment Options:

Injectable Treatments: Severe cases of pannus may benefit from steroid injections beneath the conjunctiva (the pink tissue surrounding the eye) when topical treatments alone are insufficient.

Surgical Interventions:

• Superficial keratectomy: Removal of affected corneal tissue
• Conjunctival grafts: For severe corneal damage
• Usually reserved for cases not responding to medical management

Treatment Success Factors:

Geographic Considerations: The success of pannus treatment often depends on environmental factors. Dogs living in areas with lower UV radiation typically respond better to topical treatments alone, while those in high-UV environments may require more aggressive therapy.

Age at Diagnosis: German Shepherds who are diagnosed at a young age generally have pannus that is less responsive to treatment, requiring more intensive management protocols.

Living with Pannus: Long-term Management {#management}

Dog eye care for pannus patients requires lifelong commitment and careful monitoring. Chronic superficial keratitis requires lifelong topical anti-inflammatory treatment to prevent recurrence and maintain vision.

Daily Management Routine:

Medication Administration:

• Consistent timing: Apply eye medications at the same times daily
• Proper technique: Clean hands, hold eyelid open, avoid touching dropper to eye
• Multiple medications: Wait 5-10 minutes between different eye drops
• Never miss doses: Inconsistency can lead to rapid disease recurrence

Environmental Management:

• UV protection: Consider protective eyewear (dog goggles) for outdoor activities
• Limit sun exposure: Avoid peak UV hours (10 AM - 4 PM) when possible
• Air quality: Use air purifiers to reduce airborne irritants
• Regular grooming: Keep eye area clean and free of debris

Monitoring and Follow-up Care:

Regular Veterinary Examinations:

• Initial monitoring: Every 2-4 weeks until controlled
• Maintenance visits: Every 3-6 months for stable cases
• Emergency visits: Any sudden changes in eye appearance or vision

Home Monitoring Signs:

• Increased redness or inflammation
• New lesion development
• Changes in eye discharge
• Behavior changes suggesting vision problems

Quality of Life Considerations:

Successful Management Outcomes: With proper treatment, most dogs with pannus maintain excellent quality of life. The condition is manageable, and many dogs continue normal activities including:

• Regular exercise and outdoor activities
• Training and working roles
• Social interactions with other dogs and people
• Full lifespan expectancy

Prevention and Eye Care for Dogs

While pannus prevention isn't always possible due to genetic factors, several strategies can reduce risk and support overall dog eye health.

How to Prevent Pannus in German Shepherds

German Shepherds are genetically predisposed to pannus, so prevention is all about minimizing risk factors and catching the condition early. Start with annual eye exams by the age of 3 and increase frequency to twice a year after age 5. Use UV-protective dog goggles during walks, especially in high-altitude or sunny areas. Avoid outdoor activities during peak UV hours (10 AM – 4 PM) and keep your dog’s environment free from dust and allergens. Early detection and lifestyle adjustments are your best defense.

Preventive Strategies:

For High-Risk Breeds:

• Early screening: Begin regular eye exams by age 3-4 years
• Genetic testing: Consider breeding decisions based on family history
• Environmental awareness: Minimize high-risk exposures when possible

General Eye Health:

• Regular veterinary care: Annual comprehensive eye exams
• Prompt treatment: Address any eye irritation or infection quickly
• Nutrition support: Antioxidant-rich diets may support eye health
• Exercise moderation: Avoid excessive exposure during peak UV hours

Protective Measures:

UV Protection:

• Dog sunglasses: Specialized eyewear for extended outdoor exposure
• Shade provision: Ensure adequate shade during outdoor activities
• Timing activities: Schedule walks and exercise during lower-UV periods

Environmental Controls:

• Air quality management: Regular HVAC maintenance and air filtration
• Allergen reduction: Control dust, pollen, and other irritants
• Safe play areas: Avoid areas with excessive dust or debris

Cost of Pannus Treatment 

Understanding the cost of pannus treatment helps pet owners plan for long-term care expenses associated with this chronic condition.

Pannus Dog Treatment Cost

Managing pannus involves initial diagnosis costs (typically $450–$1,100), ongoing medication costs ($35–$65 per month), and regular veterinary monitoring ($200–$600 annually). Over a dog’s lifetime, this can range from $6,000 to $12,000. Pet insurance that covers chronic conditions can help reduce the financial burden.

Initial Diagnosis Costs:

• Veterinary examination: $150-$300
• Specialized ophthalmology consultation: $200-$500
• Diagnostic tests: $100-$300
• Total initial cost: $450-$1,100

Ongoing Treatment Expenses:

Monthly Medication Costs:

• Prednisolone acetate eye drops: $25-$50 per month
• Cyclosporine ointment (Optimmune®): $40-$70 per month
• Alternative medications: $30-$80 per month
• Average monthly cost: $35-$65

Regular Monitoring:

• Follow-up examinations: $100-$200 every 3-6 months
• Annual monitoring cost: $200-$600

Lifetime Investment:

Conservative estimate for well-managed pannus:

• Annual treatment cost: $600-$1,200
• 10-year management: $6,000-$12,000
• Includes: medications, regular monitoring, and periodic adjustments

Cost-Saving Strategies:

• Generic medications: When available and appropriate
• Pharmacy shopping: Compare prices at different veterinary pharmacies
• Pet insurance: Some policies cover chronic conditions diagnosed after enrollment
• Prevention focus: Early detection reduces long-term costs

Frequently Asked Questions 

How do you treat pannus in dogs?

Treatment involves using topical corticosteroids (typically prednisolone or dexamethasone) or other immune-modulating drugs such as cyclosporine. Most dogs require lifelong medication to control the condition, with the frequency adjusted based on response to treatment.

Is pannus in dogs life-threatening?

Pannus itself is not life-threatening, but it can result in blindness if not treated properly. Early detection and consistent treatment prevent vision loss and allow dogs to maintain excellent quality of life.

What is the best treatment for pannus?

The best treatment varies by individual case, but most veterinarians start with topical corticosteroids like prednisolone acetate. Cyclosporine may be preferred for long-term management due to fewer side effects. The key is finding the lowest effective frequency to control symptoms.

Is pannus in dogs contagious?

No, pannus is not contagious. It's an immune-mediated condition affecting individual dogs and cannot spread to other animals or humans. The condition is believed to have genetic and environmental components.

Can pannus lead to blindness?

Yes, if left untreated, pannus can progress to cause significant vision impairment or complete blindness. However, with proper diagnosis and consistent treatment, most dogs maintain good vision throughout their lives.

Are there breeds immune to pannus?

No breed is completely immune to pannus, though some breeds have significantly lower risk. German Shepherds represent 90% of cases, while breeds like Labradors and Golden Retrievers have much lower incidence rates.

How often should my dog see the vet for pannus?

During initial treatment, dogs typically need examinations every 2-4 weeks until the condition is controlled. Once stable, every 3-6 months monitoring is usually sufficient, though your veterinarian may recommend different intervals based on your dog's response.

Can pannus be cured completely?

There is no cure for pannus, but it can be effectively managed with consistent treatment. The goal is to control inflammation and prevent progression rather than eliminate the condition entirely. Most dogs live normal, comfortable lives with proper management.

What happens if I miss giving my dog's pannus medication?

Consistency is crucial with pannus treatment. Missing doses can lead to rapid recurrence of inflammation and lesions. If you miss a dose, give it as soon as you remember, but don't double-dose. Contact your veterinarian if you've missed multiple doses.

Can diet help with pannus in dogs?

While diet alone cannot treat pannus, antioxidant-rich diets may support overall eye health. Omega-3 fatty acids and vitamins C and E may help reduce inflammation. Always consult your veterinarian before adding supplements to your dog's treatment plan.

Expert Conclusion: Managing Pannus Successfully

Pannus in dogs represents a manageable chronic condition when approached with proper veterinary care and owner commitment. While chronic superficial keratitis cannot be cured, the vast majority of affected dogs maintain excellent vision and quality of life with appropriate treatment.

Can Pannus in Dogs Be Cured?

Unfortunately, there is no complete cure for pannus in dogs because it’s an immune-mediated condition. However, with proper treatment, most dogs maintain excellent vision and live a full, happy life. The goal is to manage symptoms and prevent progression, not to eliminate the disease entirely. Consistent medication and regular vet check-ups are essential for long-term success.

Key Success Factors:

• Early detection through regular veterinary eye examinations
• Consistent medication administration as prescribed
• Regular monitoring with veterinary ophthalmology specialists
• Environmental management to minimize triggering factors
• Owner education about the chronic nature of the condition

For German Shepherd owners and those with other high-risk breeds, proactive eye care and awareness of early symptoms can make the difference between a minor management challenge and serious vision impairment.

Remember: Any changes in your dog's eyes warrant immediate veterinary attention. Early intervention provides the best outcomes for preserving your pet's vision and maintaining their active, happy lifestyle.

This comprehensive guide was prepared by South Florida veterinary professionals specializing in canine ophthalmology. For personalized advice about your dog's eye health, consult with a qualified veterinary ophthalmologist in your area.

Disclaimer: This information is for educational purposes only and does not substitute for professional veterinary medical advice. Always consult with a qualified veterinarian for diagnosis and treatment of your pet's specific condition.