Folded or Everted Third Eyelid in Dogs

An everted third eyelid is not life threatening, however, it can impact the field of vision of your dog. Fibrous material will typically hold the third eyelid in place, but should the support structure be defective or become injured, the third eyelid may fold over on itself, leading to this condition. An everted third eyelid is not a significant health risk for your dog, with the exception of rare instances where your dog experiences corneal irritation or develops an infection.

Easily confused with “cherry eye”, an everted third eyelid occurs when the third eyelid of one or both of your dog’s eyes folds over on itself.

In most cases an everted third eyelid in your dog will be very noticeable as there will be a mass appearing in the corner of your dog’s eye. Usually the mass is red and is often swollen. In some dogs, the mass is always present and in others in will reduce on its own. In some cases, the cornea can become irritated and there may be discharge from the eye. The everted third eyelid may occur in one eye or in both eyes at the same time. 

Types 

An everted third eyelid may occur in your dog due to inherited traits that lead to the condition, where the support structure becomes defective as a result of genetics. Even if your dog is not one of the breeds that are predisposed to the condition, an everted third eyelid can develop as a result of trauma to the eye, which causes the structural integrity to be damaged.

The third eyelid of your dog is usually held in place by a support structure of fibrous material. If the support structure is defective or if your dog’s eye becomes injured, the third eyelid may fold over itself. Some dogs may have inherited traits that lead to the condition, for example, Great Danes, Golden Retrievers, English Bulldogs and Saint Bernards. Even if your dog is not one of the breeds that are genetically predisposed to this condition, it still may develop; for example, trauma to the eye can damage the structural integrity, leading to the development of an everted third eyelid.

Everted third eyelids are easily able to be diagnosed by your veterinarian, who will look at your dog’s eye and its surrounding structures and conclude whether the eyelid is everted. In dogs under two years old, no tests will typically be conducted to confirm the diagnosis. Should your dog be older and have developed the fleshy red mass over a period of time, your veterinarian may conduct testing to ensure that he does not have a form of cancer.

Your veterinarian may take a biopsy sample for further analysis in order to understand what the mass is made up of. The biopsy may be excisional, which means the entire mass will be removed, or it may involve taking a small part only for analysis. A fine needle aspirate (FNA) may be used to get a sample from the mass. Your veterinarian may seek to conduct a thorough ophthalmic exam which will include assessing your dog’s light reflexes, his eyeball size, retropulsion of his eyeball and evaluating his intraocular pressure.

While the appearance of your dog’s eye may not be attractive when he has the condition, an everted third eyelid is not life threatening. In rare cases, the cornea can become irritated and affect your dog’s vision, and in others, an infection can develop due to your dog frequently rubbing his eye. Your veterinarian may recommend treatment for both health and cosmetic reasons; treatment is typically surgery. During surgery, some or all of the cartilage that is defective will be removed. This will lead to the third eyelid being able to unfold normally.

One option is the thermal cautery procedure which is minimally invasive and done under general anesthesia. Should an owner prefer to not have their dog undergo surgery, optical eye ointments may be prescribed in order to reduce inflammation and irritation. This will not resolve the condition but will reduce the chances that your dogs will develop an infection or have his vision compromised.

Should your dog undergo surgery for his everted third eyelid, your veterinarian will discuss how to assist him in his recovery. Your dog may have to wear a collar around his neck for a period of time so that he will be unable to interfere with the healing of his eye. It is important that you follow the recommendations of your veterinarian and attend follow up appointments as scheduled.