Cherry Eye
(Prolapsed Gland of the Third Eyelid)

Unlike man, dogs have a third eyelid, situated in the inner corner of the eye. Behind this is a pinkish tissue called the Hardarian gland.  In smaller breeds -- especially Boston terriers, Cocker spaniels, bulldogs and beagles -- the gland of the third eyelid is not strongly held in place. 'Cherry eye' is the prolapse of this gland, which then protrudes from behind the third eyelid, appearing like a cherry in the corner of the eye.


Cherry eye occasionally occurs in young puppies, usually around the age of 10-16 weeks, due to weakness in the gland's normal attachments and is thought to be an inherited abnormality.
It is becoming increasingly common in bulldogs and often affects both eyes although the second gland may prolapse several months after the first.

Previously, the prolapsed gland was treated like a small tumor; it was simply removed. This was before the full significance of the gland was realized.  Indeed, this gland is responsible for producing approximately 30% of the tear volume to the surface of the eye, while the main orbital lacrimal gland produces the rest. It is thought that should the main orbital lacrimal gland be damaged later in life that there is no "back-up" for tear production.

Thus, removal of the gland is not recommended as this can compromise tear function and can lead to development of "dry eye" later in life. Dry eye is a serious eye condition that is difficult to treat, and requires lifelong treatment which may be costly. If the chance of the development of a dry eye can be lessened by tacking the gland back into a normal position so that it stays functional, then this is the most desirable way of handling "cherry eye".

Therefore, the only acceptable treatment of cherry eye is replacing the gland to its proper location. There are two techniques for doing this. The traditional tucking method is probably most commonly performed. Here, a single stitch is permanently placed, drawing the gland back where it belongs.

In a newer surgical technique a wedge of tissue is removed from directly over the gland. This technique is more challenging as it is not easy to determine how much tissue to remove. Tiny stitches that will eventually dissolve are used to close the gap so that the tightening of the incision margins pushes the gland back in place.

Sometimes both surgical techniques are used in the same eye to achieve a good replacement. Surgery for this condition is generally done under general anesthesia. Surgery is most likely to be successful if it is done soon after the gland prolapses. The longer the gland sits in an abnormal position the greater risk that the gland will undergo damage, and not be fully functional when it is tacked back into place.

When done by a experienced practitioner or a veterinary ophthalmologist harmful complications from the surgery are unusual and 'cherry eye' has a re-occurrence rate of only 5 to 10%, on condition that the condition is treated immediately, for, with time, prolonged swelling of the gland can make repositioning more difficult and recurrence more likely.

However, if a cherry eye recurs it is important to let your veterinarian know so that a second surgery either with your normal veterinarian or with an ophthalmology specialist can be planned.

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