Eyelid Protrusion (Cherry Eye) in Cats

Although the condition known as cherry eye may appear to look painful, it is not. However, if left untreated, the gland may become painful, inflamed and irritated from exposure. If your cat rubs the eye area, the gland may become infected and even bleed. Immediate veterinary evaluation is necessary to prevent serious injury to the eye.

It is terrifying to look at your cat and see a large, reddish-pink mass bulging from its eye. This mass often looks painful, and it may seem to appear overnight. In most cases, this red mass is not a fast-growing cancer as you may have feared. Instead, it is a tear gland that is located below your cat’s third eyelid. Eyelid protrusion or “cherry eye” is a relatively common condition that occurs when your cat’s tear gland prolapses and protrudes from the eye.

There is one obvious symptom of cherry eye in cats and that is the appearance of a red mass sticking out of the corner of your cat’s eye. Cherry eye may occur in one or both of your cat’s eyes. This protrusion happens when your cat’s third eyelid is displaced and the underlying gland pushes outward and becomes visible. You may also notice a discharge coming from the eye, and the conjunctiva or membrane under the eyelid may appear red and irritated.

The third eyelid or "nictitating membrane" functions as an added protection to your cat’s eye. The gland associated with the nictitating membrane provides your cat’s eye with approximately half of its tear production. Tears also protect your cat’s eye from drying out and becoming irritated and injured. Also, the tear gland produces beneficial antimicrobial elements that fight infections and help to keep your cat’s eye hydrated and healthy.

For these reasons, it is important to have your cat evaluated by a veterinarian as quickly as possible.

The reason your cat has acquired cherry eye may be one of the following:

• Weak ligament attachment
• Defect in the retinaculum
• Congenital condition
• Inflammation
• Idiopathic (no known reason)

Although cherry eye is relatively easy to diagnose because it presents as a bulging red mass, your veterinarian will need to ensure that the mass is caused by an eyelid protrusion and not another underlying cause like cancer or injury to the eye.

• History: Your veterinarian will want a complete history of your cat’s health including when you first noticed the red mass.
• Physical Examination: A complete physical examination is necessary to evaluate the general health of your cat. This examination helps the veterinarian confirm the diagnosis and decide the best way to treat your cat’s cherry eye.
• Ophthalmic Examination: Your veterinarian may perform a thorough eye exam including taking a biopsy of the mass if necessary.

On rare occasions, your veterinarian may need to use other diagnostic tools such as ocular ultrasonography or magnetic resonance imaging (MRI) to ensure a proper diagnosis.

Although cherry eye is an unsightly and obvious deformation of your cat’s eye, surgical repair is not done for cosmetic reasons. Surgery is required to ensure your cat’s eye functions properly and to prevent serious complications from occurring.

Surgical Removal of the Gland

Removing the tear gland may seem to be an easy fix. However, once the gland is removed, your cat will be susceptible to dry eye syndrome since the normal lubrication of the eye will be compromised. Medications will need to be administered numerous times a day and follow-up visits are crucial.

Repositioning the Gland

Veterinarians usually recommend a surgical repositioning of the gland. By repositioning the gland, your cat’s eye should return to normal function with no need for daily medications.

Pocket Technique

The pocket technique is a common procedure that corrects cherry eye. Since the gland cannot be moved back into its original location, a new pocket is created close to the gland's presurgical location. The gland is positioned inside the pocket, and the pocket is closed with sutures to hold the gland firmly in place.

Orbital Rim Tacking

In some cases, the veterinarian may prefer to tack the tear gland onto the orbital rim.

You will need to attend all follow-up veterinary appointments to ensure your cat’s eye surgery was successful. In some cases, your veterinarian may need to perform additional surgery to make certain the tear gland is functioning properly and to ensure the best outcome for your cat. Inflammation and redness of the eye is common following a surgical procedure. It may take as long as two weeks before your cat’s postsurgical inflammation is resolved and the eye returns to a normal appearance. Your cat may need an Elizabethan collar to keep it from scratching or rubbing the surgical site.