Cherry Eye in Dogs

Cherry eye occurs when the tear gland of the third eyelid begins to protrude and becomes a reddish mass. Though it may look like more of a cosmetic condition than a medical one, the prolapsed lacrimal (tear) gland can become painful, irritated and inflamed. Predisposition to the condition can be seen in the Boxer, Cocker Spaniel, Lhasa Apso, Beagle, Bulldog, Shih-Tzu, Boston Terrier, Saint Bernard and Poodle breeds.

Normally, connective tissue holds the lacrimal gland of your pet’s eye in place. Weakness in the tissue or inflammation in the ocular mucous membranes are two instances that can cause the gland to protrude. For most, it is a genetic defect. Cherry eye can lead to the compromising of the function of the third eyelid. Prolapsed lacrimal glands will most often be seen in dogs under the age of two, but it can occur at any age. It is very important to bring your dog to the clinic if you see indications of a problem within the eye.

The most obvious symptom of cherry eye is the red, swollen mass in the corner of the dog’s eye which may appear suddenly. Cherry eye can progress quickly. Your canine companion may rub or paw at his eye which can lead to an infection or bleeding. If you notice a red bulge appearing in your dog’s eye, a veterinary visit is a must.

• Swollen tear gland and third eyelid
• There will be the appearance of an oval mass
• The bulge will be reddish in color
• The bulge can become irritated and painful if rubbed
• Your dog may squint if pain is present
• The eye can become dry due to lack of lubrication
• There may be swelling around the eye
• There could be a pus-filled discharge if there is a secondary infection 

Why canines suffer from cherry eye is not well understood. What is known is that the third eyelid plays an important part in tear production. If the cherry eye is not repaired, your dog could develop dry eye (keratoconjunctivitis sicca), which requires the administration of medicated ointment or drops several times daily for life.

• Weakness of the connective tissue attachment between the third eyelid membrane and tissues around the eye
• Inflammation in the mucous membrane of the eye
• Secondary infection of the third eyelid is possible with cherry eye because of exposure to environmental elements and the loss of protective moisture found in the eye
• Abnormal swelling and thickening prevent the third eyelid from returning to its normal position
• Brachycephalic breeds (with wide, flat faces) have an eye structure that may require stronger tissues; therefore, we could say they are genetically predisposed to problems with the third eyelid

You may notice that the cherry eye appearance of your dog’s eye may change in severity; at times, it could appear to be improving. However, this is a temporary improvement, and the prolapsing of the eyelid will eventually become a persistent problem. Do not delay in taking your furry companion to the clinic because the bulge can easily become injured or infected. Not dealing with the issue of prolapsed third eyelid will eventually lead to the risk of chronic conjunctivitis, persistent ocular discharge and 'dry eye'.

The veterinarian will do a thorough ocular examination, inspecting all aspects of the eye, to verify if there is a foreign object present and to check for pus related to additional infection. If your dog is a senior, testing may be done to rule out cancer. In general, though, a prolapsed third eyelid is a straightforward diagnosis.

Prompt treatment of cherry eye will bring the most successful resolution. If the prolapse is apparent for only a day or two, there is a chance that anti-inflammatories (to reduce swelling), and antibiotics may be enough to clear up the issue.

However, relapse is common and in many cases, medical treatment must involve surgical intervention. The most important part of the surgery will be to retain the tear gland. (In the past, the prolapsed lacrimal gland was often removed. Current veterinarian practice avoids this procedure.)

Two procedures are considered. The veterinarian will most likely refer you to an ophthalmologist for the surgery, as they specialize in ocular care. Of course, any infection or irritation will be attended to first, through ointments and antibiotics, before the surgery is scheduled.

• Suturing the gland in place is one technique. The gland is tacked to the orbital rim
• The pocket technique is surgery whereby a new pocket is made for the tear gland. The gland is protected by the tunnel put in place, and is tucked into the pocket, and then sutured

The prognosis for recovery of surgery for prolapsed lacrimal gland is very good. You may see one to two weeks of inflammation before the eye begins to regain its normal appearance, but 7 to 10 days of ointment application and 5 to 10 days of oral antibiotics will assure that the eye heals properly, and infection is avoided.

As with any type of surgery, allow your furry family member to rest in a quiet area for several days. Short leash walks are permitted, but swimming and bathing are prohibited for at least two weeks.

Your dog will be required to wear an Elizabethan collar for a week or two, depending on how fast the eye appears to be healing, and how much your dog is attempting to rub the eye.

The veterinarian will want to check the eye after two weeks, and it is quite possible that an ocular exam will be recommended at every check up in the future. It should be noted that dogs predisposed to the condition are more apt to have a relapse. As well, even with surgery, 20% of canines who had had the cherry eye repaired could develop dry eye in later years. Many dogs develop cherry eye in the other eye going forward.

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