Chronic immune mediated keratoconjunctivitis sicca (CIKS) is the newer name for pannus. It is most common in German shepherds, greyhounds and Siberian huskies. The cause of this condition is not known, at present. This may be an immune response to changes brought on by ultraviolet radiation. This is based on the increased prevalence of the disease at higher altitudes. Usually immune mediated CIKS starts at the outer edges of the cornea as blood vessel infiltration and then pigmentation of the cornea. As the disease progresses it spreads across the cornea to the nasal side of the eye and blindness can result from the condition. The third eyelid may become thickened and depigmented, which makes the eye look even worse. If the disease appears early in life (less than 2 yrs. old) it has a tendency to be very severe as it progresses. When it shows up later in life (4 to 5 yrs. or older) it usually is less severe. CIKS can be controlled with medical therapy, usually very successfully. It can not be cured, however. Medication is necessary lifelong for dogs with this condition. In areas of low elevation, it is usually possible to treat this with corticosteroid eye drops. In severe cases, injections of corticosteroids into the tissues surrounding the eye can be necessary. In areas of higher elevation it can be necessary to go to much greater lengths to control this problem. Irradiation of the cornea, surgical removal of the affected areas of the cornea and other measures may be necessary to provide relief from this problem.