Cherry Eye in Dogs

What is Cherry Eye in Dogs?

Cherry eye, scientifically known as prolapse of the third eyelid gland or nictitans gland prolapse, occurs when the gland responsible for producing a significant portion of your dog's tear film becomes displaced. This gland normally sits beneath the third eyelid (nictitating membrane) and remains invisible in healthy dogs. When the connective tissue holding this gland in place weakens or tears, the gland protrudes, creating the characteristic cherry-like appearance that gives this condition its name.

The third eyelid gland is vital for maintaining proper eye lubrication and health. When this gland prolapses, it not only creates a visible abnormality but also disrupts normal tear production, potentially leading to chronic dry eye (keratoconjunctivitis sicca) and further complications if left untreated.

 

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Causes and Risk Factors

The exact cause of cherry eye remains unknown, though veterinary research points to several contributing factors. The primary issue involves weakness in the connective tissue (retinaculum) that anchors the third eyelid gland in its normal position. When this tissue fails, the gland prolapses forward, becoming visible.

Contributing Factors:

Genetic predisposition plays a significant role, with certain breeds inheriting weaker connective tissue structures. Age is another key factor, as the condition predominantly affects young dogs whose tissues are still developing. Trauma or injury to the eye area can occasionally trigger cherry eye, though this is less common than genetic causes. Some cases involve inflammation of the gland itself, causing swelling that pushes it out of position.

Environmental factors like excessive eye rubbing or scratching due to allergies may contribute to gland prolapse in predisposed dogs. However, cherry eye is not contagious and cannot spread between animals or to humans.

Recognising Cherry Eye Symptoms

Identifying cherry eye early allows for prompt treatment and better outcomes. The condition presents distinctive visual symptoms that pet owners can readily recognise.

Primary Symptoms:

The most obvious sign is a red or pink mass protruding from the inner corner of the affected eye, resembling a small cherry. This mass may vary in size from a small pea to a large grape. You might notice excessive tear production or discharge from the affected eye as the exposed gland becomes irritated. Dogs often exhibit pawing or rubbing at the affected eye due to discomfort or foreign body sensation.

Secondary Symptoms:

As the condition progresses, you may observe swelling around the eye area, particularly if your dog has been rubbing it. Some dogs develop conjunctivitis (pink eye) as a secondary infection. The exposed gland may appear dry or inflamed if it's been protruding for several days. In chronic cases, decreased tear production can lead to a dull, dry appearance of the eye surface.

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Veterinary Diagnosis

Professional veterinary diagnosis is straightforward but thorough, as other eye conditions can sometimes mimic cherry eye's appearance. At Medivet, our veterinarians can conduct comprehensive eye examinations to confirm the diagnosis and assess any secondary complications.

Additional Assessment:

During examination, your vet can evaluate the gland's condition, checking for signs of infection, trauma, or necrosis. They can assess whether the gland can be temporarily repositioned (though it typically prolapses again quickly). The examination also includes checking for other eye abnormalities that might complicate treatment or recovery.

Early diagnosis significantly improves treatment success rates and reduces the risk of complications like chronic dry eye or corneal damage.

Treatment Options for Cherry Eye

Treatment for cherry eye varies depending on severity, duration, and your dog's overall health. While mild cases might initially respond to medical management, surgical intervention remains the definitive treatment for most dogs.

Medical Management:

In very early or mild cases, your vet might prescribe anti-inflammatory eye drops to reduce swelling and irritation. Lubricating eye drops help maintain moisture while awaiting surgery.

Medical management alone rarely resolves cherry eye permanently. Most cases require surgical correction to prevent recurrence and preserve gland function.

Surgical Treatment:

Surgery offers the best long-term outcome for cherry eye. Modern surgical techniques focus on preserving the gland rather than removing it, as the gland's tear production is vital for eye health. Two primary surgical approaches exist:

Pocket technique (Morgan pocket):

The surgeon creates a pocket of conjunctival tissue and tucks the prolapsed gland inside, securing it with sutures. This technique has high success rates and preserves gland function.

Anchoring technique:

The gland is sutured directly to deeper orbital tissues, returning it to its anatomical position. This method can work well for larger dogs or severe prolapses.

Cherry Eye Surgery Details

Understanding the surgical process helps prepare you and your pet for the procedure and recovery period. At Medivet, our experienced teams perform cherry eye corrections regularly, using modern techniques and equipment for optimal outcomes.

Pre-Surgery Preparation:

Your dog can undergo pre-anaesthetic blood tests to check organ function and blood cell counts. Fasting for 12 hours before surgery can help prevent complications during anaesthesia. The surgical team will discuss anaesthetic risks specific to your dog's breed and age. You'll receive post-operative care instructions before the procedure begins.

The Surgical Procedure:

Surgery typically takes 20-45 minutes per eye. Your dog can receive general anaesthesia and pain medication for comfort. The surgeon can carefully clean and prepare the eye area before beginning. Using magnification, they create precise incisions to either pocket or anchor the gland. Absorbable sutures secure the gland in its new position. The team monitors your dog's vital signs throughout the procedure.

Immediate Post-Surgery:

Your dog wakes in a quiet recovery area with trained staff monitoring closely. They'll wear an Elizabethan collar (cone) to prevent eye rubbing. Most dogs go home the same day with medications and detailed care instructions.

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Post-Surgery Care and Recovery

Proper post-operative care significantly influences surgical success and prevents complications. Recovery typically takes one to two weeks, during which careful monitoring and medication compliance are vital.

Immediate Post-Operative Care (Days 1-3):

Keep the Elizabethan collar (cone) on continuously to prevent eye rubbing or scratching. Administer prescribed medications  exactly as directed.  Limit activity to short toilet breaks on a lead. Monitor for excessive swelling, discharge, or signs of pain.

Ongoing Recovery (Days 4-14):

Continue all medications until completed, even if the eye looks normal. Keep the protective collar on until your vet approves removal. Attend your follow-up appointment (usually at 7-10 days) for suture check and healing assessment. Gradually increase activity levels as healing progresses. Watch for any signs of gland re-prolapse or infection.

Long-term Management:

Your vet can assure you of the best long-term management. After recovery, regular eye examinations help detect any recurrence early. Some dogs benefit from ongoing lubricating drops, especially if tear production decreases. Monitor the other eye, as bilateral cherry eye can develop weeks or months later.

Managing the Condition Long-term

Even after successful surgery, ongoing vigilance helps maintain your dog's eye health and prevents complications. Cherry eye can recur, making regular monitoring important.

Regular Health Checks:

Schedule routine veterinary examinations every six months to assess eye health. During these visits, your vet can perform tear production tests and check for early signs of dry eye. They'll examine both eyes, as dogs who develop cherry eye in one eye have increased risk in the other.

Home Monitoring:

Learn to recognise early warning signs of eye problems. Check your dog's eyes daily for redness, discharge, or swelling. Notice any behavioural changes like increased blinking, squinting, or eye rubbing. Keep the eye area clean using veterinary-approved wipes or solutions.

Preventive Measures:

While you cannot prevent genetically-predisposed cherry eye, you can reduce complications. Keep your dog's face clean and dry, especially in breeds with facial folds. Trim facial hair that might irritate eyes. Use harnesses instead of collars to reduce pressure that might affect eye health. Consider protective eyewear during activities that risk eye trauma.