Cherry Eye (Third Eyelid Gland Prolapse) in Dogs

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Key takeaways


Dogs have a third eyelid, visible as a pink membrane mostly hidden under the inside corner of the eye. When the bulbous, dark pink gland of the third eyelid slips out of place and becomes visible, this is called a “cherry eye.”

  • The nictitans gland is responsible for much of the eye’s tear production, and maintains the shape of the eyelid allowing for distribution of tear film across the eye
  • A prolapsed gland still manufactures tears, but its function is impaired and the eye becomes irritated over time
  • Complications include keratoconjunctivitis sicca, conjunctivitis, and excessive ocular and nasal discharge
  • Treatment is surgical to tack down the affected gland and hold it in place
  • Prognosis is good, although a future recurrence is always possible
  • Cherry eye usually has no known root cause, although breed predisposition has been identified
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A closer look: Cherry Eye (Third Eyelid Gland Prolapse) in Dogs


The nictitans gland of the third eyelid is responsible for secreting tears to lubricate the eye and for maintaining the shape of the outer eyelids, which ensures distribution of tears over the eyeball. When the gland prolapses out of the eye socket, these processes become compromised. Inadequate lubrication of the eyeballs can develop into more serious ocular conditions which, left untreated, may result in damage to the eye and loss of vision.

Cherry eye is more common in younger dogs.

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Risk factors


Cherry eye is more common in younger dogs, especially in breeds with an apparent genetic predisposition. The displaced gland usually still functions, and the condition doesn’t usually cause discomfort, so it is not considered a medical emergency. Non-urgent medical attention is recommended, as an uncorrected cherry eye leads to chronic inflammation and complications like keratoconjunctivitis sicca (KCS) and conjunctivitis. Left untreated, these can seriously impair vision.

Possible causes


Cherry eye is idiopathic, meaning it has no known root cause. It is believed that weak connective tissue holding the nictitans gland in place is responsible for the prolapse, however it is unclear what the underlying mechanism causing weakness is. It may be genetic, as there are some breeds of dog that are more susceptible to the condition, including cocker spaniels, English bulldogs, and Pekingese, among others.

Main symptoms


Cherry eye presents as a bulb of pink flesh bulging out of the bottom inner corner of the eye. It comes on suddenly and may recede on its own, although any apparent recovery is temporary. If a cherry eye develops in one eye, it is likely to develop in the other.

Cherry eyes don’t usually lead to any other symptoms until complications arise when left untreated.

Testing and diagnosis


Cherry eye is visually self-evident, and a vet only needs a physical examination of the eye to confirm the presence of the gland prolapse.

Steps to Recovery


The goal of surgical treatment is to create a pocket for the prolapsed gland and affix it back down, holding the gland in its proper place.

The non-urgent nature of cherry eye means it is common for a vet to allow some time before surgically repairing it. There is a chance that the other eye will develop a prolapse as well. Postponing surgery allows correction to be performed on both eyes concurrently, and along with other surgical procedures performed early in life, such as sexual alteration or hernia repair.

Historically, it was common to remove the prolapsed glandular tissue. It has since been determined that tears produced by the gland are important for overall ocular health, and this operation is no longer recommended.

With treatment, the gland usually recovers within weeks. After surgery, oral NSAIDS (anti inflammatory medications), ophthalmic antibiotics, and an e-collar are usually prescribed. The prognosis is favorable, although future recurrence is common, requiring repeated surgeries.

Prevention


As an idiopathic condition, preventing cherry eye is not always possible. The best method of doing so is selective breeding, avoiding breeding dogs that are susceptible to the condition.

Is Cherry Eye (Third Eyelid Gland Prolapse) in Dogs common?


Cherry eye is not a common condition, although in some breeds it is more common than others.

Typical Treatment


  • Surgery

References


Brittany Grenus, DVM - Writing for PetMD
Wendy Brooks, DVM, DABVP - Writing for Veterinary Partner
Ryan Llera, BSc, DVM; Ernest Ward, DVM - Writing for VCA Animal Hospitals

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