Cherry Eye (cherryeye)
of the Condition
The gland of the third eyelid is located within the base of the
third eyelid. The third eyelid (nictating membrane) lies between
the lower eyelid and the eyeball at the inside corner of each
eye. The third eyelid protects the eye and helps contain and distribute
tears over the surface of the eye. The third eyelid gland is a
tear-producing gland. This gland is responsible for contributing
30-40 percent of the normal tear volume.
This is commonly
referred to as "Cherry Eye." Enlargement (hypertrophy) of the gland
is usually associated with the prolapse. The prolapse can occur
in one or both of the eyes, yet one eye may precede the other by
weeks to months. The cause for the prolapse is believed to be partially
due to a weakness of the connective tissue attachment of the gland
to the periorbita. Old timers believe "Cherry eye" is often seen
as a direct result of puppies after playing on carpet, rubbing their
face, or playing in in the dirt. The tear duct becomes blocked,
and obstructs tear flow. After a couple of days it begins to swell
because now an infection has begun. Once the BLOCKED tear duct swells,
there is no room for it in it's present position, and even strong
tissue cannot hold it. Thus the result is a cherry eye. This same
situation happens a lot in newborn human babies who do not have
good tear flow at birth and their tear ducts become blocked with
the semi-solid matter that develops in the corners of their eyes.
Breeds predisposed to prolapse include Cocker Spaniel, Bulldog,
Lhasa Apso, Beagle, Bloodhound, Boston Terrier, Bull Terrier, and
St. Bernard, and the Burmese cat.
of the gland of the third eyelid results in a pink to red
mass in the inner corner of the eye (see photo to the right).
the hypertrophied and prolapsed third eyelid gland to its normal
position will preserve tear production, enhance appearance, and
prevent corneal and conjunctival disease caused by the prolonged
exposure. Surgically replacing the gland to its normal position
is especially important in breeds (Bulldog) that are also prone
to develop tear insufficiency disease (dry eye). Surgical removal
of the prolapsed gland could precipitate the development of dry
eye syndrome and this is a very serious disease.
Options for the Condition
There are old timers with extensive experience with "Cherry Eye
Condition" that recommend an alternative to surgery, especially
those breeds that have high surgical risks. The first thing that
is done to "treat" this condition is to prescribe an antibiotic
ointment, second use warm compresses to the corner of the eye,
third is to massage the gland lightly with the index finger applying
even gentle pressure in a circular motion. Once the tear duct
becomes "unblocked" even if it is out of its normal place it is
now of a size that usually can be returned by pulling very gently
the outer tissue and "popping" the tear duct back into place.
You may have to replace the tear duct several times over a two
week period, sometimes I have heard for even a month, but then
it does not require surgery, and the dog as a general rule has
no more problems with the condition whatsoever. We urge new pet
owners to be very careful when attempting to use this technique
because you can cause injury to the eyeball if you scratch it
when trying to massage the tear duct. Try to find another owner
of a bulldog or similar breed to walk you through it the first
time to make sure you are doing it correctly. We do urge you to
seek veterinarian assistance if the condition worsens or if this
technique fails to make an improvement. There are some bulldogs
that have an inflamatory disease as well and you may see a worsening
of the condition. Inflamatory conditions must be treated with
an anti-inflamatory antibiotic drop or ointment.
There are several different techniques for replacing the gland,
surgically and manually. Surgery requires general inhalation anesthesia,
but your pet can go home the same day as surgery once fully recovered.
Surgery is performed under strict aseptic conditions. Please
make sure your veterinarian is familiar with the special anesthesia
needs of Bulldogs, and is experienced in the surgical procedure
of "cherry eye".
The most popular
and successful surgical technique is called the Conjunctival Mucosa
Pocket Procedure which creates a pocket to place the prolapsed
gland inside and then the pocket is closed with very fine absorbable
opthalmic sutures. Another method is to merely suture the replaced
gland again with very fine absobable opthalmic sutures.
Another procedure, which we do not recommend, is the removal of
the gland. This procedure often leaves your pet with VERY
inefficent tear flow which can lead to the serious problem
of dry eye, and can result in permanent corneal damage.
Recommendations for the surgical procedure
Some swelling and redness of the third eyelid and lower eyelid
is normal after surgery. Keep the eye clean of discharges.
Mucoid discharges trap bacteria and inflammatory cells and inactivate
medications. We recommend you use Bausch & Lomb Sensative
Eyes Saline Solution and white tissues to clean the eye. The saline
solution can be directly irrigated into the eye.
for the first postoperative week may be normal if the airway is
sore from the tracheal tube used for inhalation anesthesia. If
coughing is severe, please call your veterinarian or opthamologist.
your pet's activity for the frist 2 weeks after surgery to enhance
retention of the gland.
antiobiotic and anti-inflammatory eye medication is prescribed
to try and prevent infection and to minimize inflammation, but
cannot be used if there is a scratch on the surface of the eye.
Carefully monitor the cornea for an irregularities. Squinting
can also indicate a corneal injusry. If any concerns, stop the
medication and call us.
pet may rub at the eye. Distract your pet with treats or attention
when this occurs. Some pets may beed a restraint collar which
you can borrow from us or from your referring veterinarian.
A very rare
pet will develop a re-prolapse of the gland. Though this is very
dissappointing, the surgery can be repeated and is usually successful
at this time.
by Stephanie Burr