Did you know dogs have a third eyelid? The third eyelid or nictitating membrane is a structure that sweeps over the surface of the eye. It spreads the tear film across the cornea and protects the eye. It’s usually only possible to see the edge of the third eyelid, which is located in the lower corner of the eye near the nose.

There’s a tear gland located behind and deep to the third eyelid that isn’t usually visible. This eyelid gland has an important function of tear production and contributes a significant amount of the normal tear volume of the eye in healthy dogs. Adequate tear production is essential to keep the surface of the eye lubricated and healthy.

Third eyelid gland prolapse occurs when this gland moves from its deep location and protrudes over the free edge of the third eyelid. This prolapsed third eyelid gland appears as a pink swollen mass in the corner of the eye. Because of this it’s commonly referred to as 'cherry eye'.

Although dog cherry eye isn’t usually painful, it’s often associated with conjunctivitis. This means that the prolapsed gland may become inflamed and lead to lowered tear production. If this happens there’s a risk of developing “dry eye”. Third eyelid gland prolapse can affect one or both eyes.

What Causes Cherry Eye in Dogs?

It’s not known what causes a cherry eye on a dog (third eyelid gland prolapse), but it may be a genetic issue in some dogs. Younger dogs typically tend to be affected. Cherry eye is more common in certain dog breeds, like the American Cocker Spaniel, English and French Bulldogs, Shi Tzu, Lhasa Apso, Pekingese, Shar Pei, Beagle, Great Dane, and Mastiff breeds.

Symptoms of Cherry Eye in Dogs

If a dog develops cherry eye, in the early stage you will notice a red, swollen mass protruding from the corner of your dog’s eye. The third eyelid may also be more noticeable than usual. Over time the mass may become more noticeable and may become traumatised if your dog rubs at it. Cherry eye can affect your dog’s quality of life, so you’ll need to take your dog to see your vet for treatment.

Cherry Eye in Dogs Treatment

The only effective cherry eye in dogs’ treatment is to surgically return the gland to its normal position by performing cherry eye surgery. There are a number of ways this can be done. The simplest and most effective technique involves burying the gland in a pocket of conjunctiva (the soft lining inside the eyelids) behind the third eyelid and then suturing the pocket closed. This method has a high success rate and allows the third eyelid to continue to move normally. 

Following surgery, a short course of antibiotic eye drops and pain relief, anti-inflammatory tablets, oral liquids are given. There are other surgical techniques available, and these may be used in selected patients or in some rare cases when the 'pocket' technique has previously been unsuccessful. Surgical removal of the third eyelid gland isn’t recommended, because in more than 50% of cases it will lead to the development of 'dry eye' (keratoconjunctivitis sicca). Dry eye is painful and can result in blindness.

Your vet will be able to advise you on the best treatment for cherry eye in your dog. It can feel daunting for your dog to have to undergo eye surgery. It’s a relatively straight forward procedure, so your vet should be able to put your mind at rest. 

You can ask your vet how to treat cherry eye in dogs without surgery, and whether this is an option, and they will be able to advise you. They may try to manipulate the gland back into place manually without surgery, but more often than not, it will unfortunately pop right back out again.

It’s worth asking your vet for the costs of cherry eye in dogs surgery. There may be a significant difference in the cost of different procedures, particularly if your vet feels your dog requires referral to a specialist veterinary ophthalmologist.
 

Complications of Dog Cherry Eye Surgery

The most common complication of dog cherry eye surgery is a condition called “dry eye”. This happens when the prolapsed gland has been damaged and has stopped producing enough tears. If this happens, the dog develops dry eye and will need treatment for this. Your vet will monitor for this condition by measuring your dog’s tear production with a simple and painless test known as the Schirmer Tear Test (STT).

The STT involves your vet placing a small strip of paper just inside your dog’s lower eyelid for 60 seconds. The paper has a small line of dye on it and as the paper absorbs your dog’s tears, the dye moves up the strip and the distance can be measured by your vet.

A healthy dog produces enough tears to move the dye up the paper a certain distance. If your dog is not producing enough tears, then the dye will not move as far up the paper as it should. Most dogs tolerate the test well and although it may feel a bit strange, it isn’t painful for them.

Your vet may also put an orange or green dye in your dog’s eye, called fluorescein. This checks the front of the eye and shows up any damage to the surface of the eye (cornea). The dye is harmless but may stain your pet’s fur a little bit and it can stain your clothes. It’s normal for this dye to also appear at your dog’s nostrils a short while after the procedure!

Cherry eye in dogs is an unpleasant but perfectly treatable condition. It’s important to seek veterinary help as soon as you notice anything wrong. The earlier you get your dog to see your vet the quicker they can get your dog back to normal.

The health of the eye is as important as your dog’s overall health. If you’re thinking of breeding from your dog, ask your vet about the likelihood of this being a genetic condition in your dog’s breed before you go ahead.

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Content provided from Vetstream's Vetlexicon Canis: www.vetlexicon.com/canis

Vetlexicon is the world’s largest peer-reviewed online clinical reference source. All our content is written and peer-reviewed by over 1,000 of the world’s leading veterinarians, ensuring relevance, accuracy and quality.