A cherry eye is the prolapse of the gland of the third eyelid. The appearance is a red lump at the inner eyelid corner. The cause of this condition is unknown but it is common in certain breeds. Breeds that are predisposed include Basset Hound, Maltese, Beagle, British Bulldog, Australian Bulldog, Cocker Spaniel, Rottweiler, Shih Tzu and Neapolitan Mastiff.
We see cherry eye mostly in younger dogs. Often it will develop in the other eye around the same time. In some cases the cherry eye can be associated with eversion (kinking) of the third eyelid cartilage.
The only option for treatment is surgery as drops and ointments will not resolve the gland prolapse. These medications may help by reducing the associated swelling and inflammation (redness).
Surgery involves permanently repositioning the gland using a pocket technique. A pocket is created into which the gland sits and the conjunctiva is sutured together over the top. This technique has a very high success rate with a recurrence rate of less than 2% at Animal Eye Care. If the gland is not repositioned it can enlarge and cause complications such as conjunctivitis, a corneal ulcer or dry eye.
Third Eyelid cartilage eversion
Some cases initially diagnosed as cherry eye are in fact everted (kinked) third eyelid cartilage, and many cases of cherry eye can have some deformed cartilage. The kinked piece of third eyelid cartilage is excised and in most cases routine cherry eye surgery is performed. In some breeds due to laxity of the third eyelid and lower eyelids the third eyelid may sit out slightly from the eyeball and there may be slight prominence of the gland. In some dogs this is unavoidable however we do our best to have the best cosmetic outcome possible. This is a more common problem in breeds such as Neapolitan Mastiff, Bulldogs and Basset Hounds.
Cherry Eye in a Maltese
Removal of the Third Eyelid gland
We do not advise removal of the gland as this can result in dry eye. The third eyelid gland produces between 30-60% of the tears that bathe and protect the eyeball. It may seem like a quick fix however complications associated with dry eye can be severe, painful and costly. Medical therapy is not usually effective.
This only treats the symptoms, whereas surgery is directed towards getting the gland to function normally. When the third eyelid gland has been removed, the associated dry eye can be very difficult to treat and surgery such as a parotid salivary duct transfer may be required. It may take 3 weeks to 5 years after third eyelid gland excision for the dry eye to develop.
Dogs that have had cherry eye and had surgical correction are still at risk of developing dry eye however the risk is much lower.
Association between Cherry Eye and Dry Eye
Surgical correction: 12% rate of dry eye
Do nothing: 40% rate of dry eye
Cut out TE gland: 50% rate of dry eye
The inheritance of cherry eye is not really known but is suspected in some breeds. It certainly seems to be a familial condition – being more common in certain family lines. This is thought to be related to conformation/shape of the third eyelid and its cartilage. We recommend that breeders use caution when breeding with an affected dog. If many of their progeny are affected we would not recommend further breeding with that dog.