5 Things to Know About Cherry Eye (Eyelid Protrusion)

Despite the angry red appearance that a “cherry eye” (prolapsed nictitans gland) sometimes has, this condition is not painful for dogs.

By: imagesbywestfall
She doesn’t have cherry eye — but if she did, you would know it on sight. (See the photo below to see what it looks like.) By: imagesbywestfall

Cherry eye gets its name from the appearance of a round, red swelling at the inside corner of the dog’s eye.

The red swelling is actually a gland that normally sits on the inside of the third eyelid, quietly producing tear fluid to lubricate the surface of the eye.

When this gland (called the nictitans gland) pops out of the pocket in which it normally sits (or prolapses), it becomes visible, looking like a small red cherry sitting on the eyelid.

Despite the angry red appearance that the prolapsed gland sometimes has, this condition is not painful. The displacement of the gland reduces the lubrication on the corneal surface, however, and can predispose the patient to eye infections or corneal ulcers.

Cherry eye is a condition of young dogs between 6 and 24 months of age. Certain breeds, especially those with large eyes and flatter noses, are more likely to develop cherry eye than others, including the Bulldog, French Bulldog, Lhasa apso, Beagle, Pekingese, mastiff, Great Dane and Cocker Spaniel.

1. Symptoms

The most obvious symptom is a visible, cherry-sized red lump sitting on the eyelid at the inside corner.

One or both eyes may be affected. Sometimes the displaced gland rubs against the surface of the eye and causes additional reddening of the cornea.

2. Causes

The “cherry” is the nictitans gland that is a normal part of the third eyelid — the extra eyelid that dogs and cat have at the inside angle of the eye. This eyelid flicks across the cornea to protect it from scratches.

The nictitans gland is usually secured into a pocket behind the third eyelid by fibrous attachments that anchor it down.

If these attachments are too lax, this allows the gland to move around and pop out of position.

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3. Diagnosis

This is a simple case of looking with the naked eye — no further tests are necessary if the obvious cherry-like swelling is present. That said, the clinician will look for secondary damage such as a corneal ulcer caused by lack of lubrication.

4. Treatment

In the short term the eye should be kept well lubricated, with the application of false tears if necessary.

The treatment is surgical repositioning of the gland back in its pocket. There are 2 ways of doing this.

  1. The first technique involves suturing the gland to the periosteum (the tough membrane that covers bone) of the skull. When the sutures hold, this is a great solution — however, it has about a 50% failure rate, meaning that repeat surgery is necessary.
  2. An alternative method involves creating a tuck or fold in the membrane of the third eyelid and suturing the gland inside back in its original position.

This video shows a veterinarian pushing the third eyelid back into place in the office, although this solution may only be temporary:

These last techniques have superseded an older procedure that used to be popular, which involved removing the gland. But because the gland produces tear fluid, this decreased moisture to the eye by around 70%, which in some cases was enough to cause “dry eye,” where the eye gets sore because it is not well lubricated.

5. Prevention

Unfortunately, there is no known prevention. With successful surgery, the problem can be remedied.

References

  • Small Animal Ophthalmology. Pfeiffer & Petersen-Jones. 3rd edition. Publisher: W.B. Saunders.
  • “Prolapse of the gland of the third eyelid in dogs.” Morgan, Duddy & McClug. JAAHA, 29: 56–60.

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This pet health content was written by a veterinarian, Dr. Pippa Elliott, BVMS, MRCVS. It was last reviewed Jan. 23, 2015.

Dr. Pippa Elliott, BVMS, MRCVS

View posts by Dr. Pippa Elliott, BVMS, MRCVS
Dr. Pippa Elliott, BVMS, MRCVS, is a veterinarian with nearly 30 years of experience in companion animal practice. Dr. Elliott earned her Bachelor of Veterinary Medicine and Surgery from the University of Glasgow. She was also designated a Member of the Royal College of Veterinary Surgeons. Married with 2 grown-up kids, Dr. Elliott has a naughty puggle called Poggle, 3 cats and a bearded dragon.

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