Summary

Cherry eye is the prolapse (i.e. abnormal positioning) of the lacrimal gland in the third eyelid. Lacrimal glands are the part of the eyes that produce tears, which help keep the eyes moist and protect them from injuries. Lacrimal glands can be found in several places in the tissues surrounding the eye. The third eyelid, also known as the nictitating membrane, is not like the typical upper and lower eyelids seen with most animals and people. It actually lies just under the lower eyelid and can usually only be seen at the inner corner of the eye. It is often only noticeable when it raises up to either cover a portion of the eye (e.g. when a dog or cat is sleeping).

When a dog or cat has cherry eye, the lacrimal gland, found in the upper, inner corner of the third eyelid, slips out of place. This can lead to swelling, decreased tear production, and inability to completely close the eye. Researchers have not been able to fully understand why this happens, but they suspect the risk for cherry eye is something a pet is born with. Sometimes cherry eye will occur in both eyes, although it is more common in just one.

Symptoms and Identification

When a pet has cherry eye, the third eyelid will appear swollen and look more prominent than normal. A small, often pink or red, round mass or bulge is often seen at the inside corner of the eye. The pet will usually produce mucous-like tears from the eye instead of normal, clear tears. This occurs because the gland has trouble producing enough tears to keep the eye moist. It may also occur because cherry eyes can lead to eye infections more easily. Sometimes the eye itself will seem swollen or red, especially when compared with the healthy eye.

To identify or diagnose cherry eye, veterinarians perform a thorough eye examination. Sometimes sedation is necessary. Although rare, cherry eye can look more like cancer or a tumor, so ensuring a correct diagnosis is important.

Affected Breeds

Cherry eye in dogs is most common in:

Most dogs are under two years of age when they are diagnosed, although cherry eye can happen at any age.

Cherry eye in cats is rare, but Burmese and Persian breeds may be slightly more susceptible than other breeds.

Treatment

Most cherry eyes require surgery to fix them. In many cases, the prolapsed gland is placed back into the correct position with sutures (i.e. stitches). If this type of surgery doesn’t solve the problem, the gland may need to be surgically removed.

After surgery, the pet will need an Elizabethan collar (i.e. e-collar or cone) to keep them from rubbing the eye and breaking down the sutures. Medicated eye ointment or drops are also commonly prescribed to help keep the eye moist, allow it to heal, and to prevent infection.

If surgery is not an option, or if the gland is surgically removed, the pet will often need to be kept on eye drops for life, such as artificial tears, to keep the eye healthy and moist. Consequences of not treating cherry eye include eye infections and keratoconjunctivitis sicca (i.e. KCS), a condition also known as chronic dry eye.

Veterinary Cost

Cost of cherry eye surgery ranges from $300-$800 depending on which procedure is performed and how severely the eye is affected. Monthly medication cost for medical treatment is usually $25-$75 depending on which medications are needed.

Prevention

Unfortunately, nothing can prevent cherry eye. Preventing additional issues associated with a cherry eye (i.e. KCS, infections) includes keeping the eye moist with appropriate eye drops and treating any new eye issues as soon as they are noticed.

References

1. Ae Park S, Taylor K, et al: Gross anatomy and morphometric evaluation of the canine lacrimal and third eyelid glands. Vet Ophthalmol 2016 Vol 19 (3) pp. 230-36.

2. Morgan RV, Duddy JM, McClurg K: Prolapse of the gland of the third eyelid in dogs - A Retrospective study of 89 cases (1980-1990). JAAHA 1993 Vol 29 (1) pp. 56-60.

3. Mazzucchelli S, Vaillant M D, Wéverberg F,et al : Retrospective study of 155 cases of prolapse of the nictitating membrane gland in dogs. Vet Rec 2012 Vol 170 (17) pp. 443.

4. Edelmann M L, Miyadera K, Iwabe S, et al : Investigating the inheritance of prolapsed nictitating membrane glands in a large canine pedigree. . Vet Ophthalmol 2013 Vol 16 (6) pp. 416-22.

5. Saito A, Izumisawa Y, Yamashita Ka, et al : The effect of third eyelid gland removal on the ocular surface of dogs. Vet Ophthalmol 2001 Vol 4 (1) pp. 13-18.

6. Albert RA, Garrett PD, Whitley RD, Thomas KL: Surgical correction of everted third eyelid in two cats. J Am Vet Med Assoc 1982 Vol 180 (7) pp. 763-6.

7. Chahory S, Crasta M, Trio S, Clerc B: Three cases of prolapse of the nictitans gland in cats. Vet Ophthalmol 2004 Vol 7 (6) pp. 417-9.

8. Eordogh R, Schwendenwein I, Tichy A, et al: Clinical effect of four different ointment bases on healthy cat eyes. Vet Ophthalmol 2016 Vol 19 (Suppl 1) pp. 4-12.

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