What is a Cherry Eye?

Cherry Eye       By Janice Jones M.A.   |Last Updated 04-06-2020

Whether you believe that a cherry eye is a cosmetic problem or a serious medical condition, you probably have to agree that it is not the easiest sight to behold.

Getting its name from the fact that it seems to resemble a bright red cherry, the correct medical term for this odd looking mass is a prolapse gland of the third eyelid or nictitating membrane.  This is an important structure of the eye because it assists in spreading the precorneal tear film over the eye to protect it from injury.

This condition is normally seen in younger dogs but if it occurs in older dogs, the cause is likely some type of neoplasia of the third eyelid.

Unlike people, dogs have a third eyelid or membrane that contains the glands that produce tears.  When the tissue that holds these glands weakens, they will pop out so what you see is a small mass which looks like a cherry.

Once the gland pop is out and visible, it can become swollen and even become infected.

You would think that a cherry eye is painful to the dog, but it usually is not.  The main problem that unfolds is the lack of adequate tear production to lubricate the eye, causing the dog to experience a dry eye.

However, this is not always the case because as long as the gland is still intact, tear production continues.

Dog Breeds Affected

Cherry eye is common in small dogs, especially young ones.  Breeds with short muzzles such as Boxers, Bulldogs, Pugs, and Boston terriers are more prone to developing this condition.

But it is also seen in Beagles, Lhasa Apso, West Highland White Terriers, Cocker Spaniels., and Cavalier King Charles Spaniels. I

It can also occur in cats, but with less frequency. 

There seems to be some disagreement as to whether it is a problem that needs to be fixed or simply a cosmetic issue causing the dog to have a rather peculiar appearance.  

There even seems to be controversy over whether the membrane should be removed or just tucked back into place.

Signs and Symptoms of Cherry Eye

The only symptom is the noticeable red circular mass that protrudes from the side of the dog’s eye. This swollen membrane in the corner of the dog's eye often appears suddenly and unexpectedly. 

Sometimes dogs will rub or paw at their eye which can irritate it further.  In other cases, the dog does not appear to be bothered by it and it is generally assumed to not cause pain.

It can occur in one or both eyes. 

When the tissue is exposed, it can It can lead to bacterial infections. trauma, and swelling.  

Causes

Since the condition seems to follow certain breed lines, it is likely an inherited problem.   According to Dr. Karen Becker, the cause isn’t well understood. 

It is however believed to be weakness of the connective tissue ligaments that holds the glands in place.  Stress or trauma to the area are also possible causes especially in dogs that already have a genetic susceptibility.  

Diagnosis

The veterinarian will make a diagnosis after observing the mass.  Tumors need to be ruled out if the dog is older and the veterinarian will also take breed into consideration when making the diagnosis.

Treatment

Treatment options can fall into two categories:  medical and surgical.  Of course, the other option is to do nothing. 

Medical Interventions

Medical interventions sometimes work if they are begun immediately after the gland pops out.  Antibiotic and Steroid eye drops are often prescribed but may prove to be ineffective.  Medical treatment is often prescribed as a way to alleviate the problem without the cost of the surgery.

Surgical Treatment

If medical treatment fails, it’s time for surgery.  There are three options available.  Veterinarians can suture the gland back where it belongs or they can remove it entirely.

Another option is called a pocket procedure where two small incisions are made.  Then, the membrane is inserted into the "pocket." This surgery allows the membrane and the tear ducts to remain intact.  If the third eyelid or membrane becomes dislodged again, the surgery will need to be repeated.

A partial removal technique will remove only the affected area and leave the rest intact.  The vet will try to save as much of the tear duct as possible, but there is still a chance that the membrane will become inflamed again at some point.  Dry eye is also a possibility.  More about dry eye in a moment.  

If your veterinarian chooses to remove the gland, the dog may be susceptible to dry eye or Keratoconjunctivitis sicca or KCS.  This is a chronic degenerative conjunctivitis that does not have a favorable outcome, leading to vision problems and blindness.   

If this happens the cornea dries out due to inadequate tears.  Owners must apply eye drops daily to keep the eye lubricated; otherwise the vision is likely to be affected in the eye.

Regardless of the type of surgery, general anesthesia is required.   Most of the surgeries to correct Cherry Eye are fast and have very few complications. 

Most animals go home the same day after they recuperate from anesthesia.  After the surgery, some animals are prescribed antibiotics and anti-inflammatory medications and antibiotic eye drops are recommended.

The worst part of the surgery in the dog's mind is having to wear the dreaded e-collar (commonly called the cone of shame) until the eye heals.  Some dogs will not bother the eye by pawing and scratching, but that is rare, so it is better to be safe (with a collar) than without one.

Costs Associated with Surgery

According to Embrace Health Insurance a typical surgery can run from $500 to $650 which would include the surgery, anesthesia and accompanying medications.

References

Common Diseases of Companion Animals by Alleice Summers, 3rd Ed.

https://www.bulldogology.net/bulldog-cherry-eye-treatments/