A Comprehensive Guide to Cherry Eye in Dogs

Key Points

• Cherry eye in dogs is a common condition that requires immediate veterinary attention.

• Non-surgical treatment approaches may only manage the early stages of cherry eye.

• Surgical treatment is necessary to treat cherry eye in dogs.

• Common cherry eye symptoms include a red, building mass in the inner corner of the eye.

• The red mass is not a tumor; the tear glands are sliding out of their original position.

Caring for our beloved canine companions involves understanding and managing various health issues that may affect their well-being. One of the common health concerns is the "cherry eye." While it may sound harmless, cherry eye in dogs is a concerning eye condition that impacts dogs' tear glands, and its complications may lead to complete vision loss.

Cherry eye in dogs is more prevalent in certain breeds, making it important for owners of these breeds to be vigilant and proactive in diagnosing the issue. If you worry about your dog having cherry eye and want to learn more about this vision problem, this comprehensive guide explains its causes, symptoms, treatment options, and preventive measures.

What Is Cherry Eye?

The clinical term of cherry eye is nictitans gland prolapse or third eyelid gland prolapse. The condition occurs when the tear gland in the dog's inner corner protrudes or falls out of its original position. The gland, scientifically known as the third eyelid gland or nictitans gland, typically plays a crucial role in tear production and maintaining proper eye lubrication.

This gland becomes visible and swollen in dogs that suffer from cherry eye. Over time, the gland turns into a reddish mass that resembles a cherry. Cherry eye may occur unilaterally (affecting one eye) or bilaterally (affecting both eyes).

Anatomy of the Dog's Eye

It's essential to have a basic grasp of a dog's eye anatomy to understand the eye condition fully. A dog's eye consists of several important components, each vital in its overall function.

The outermost layer of the eye is the cornea. It acts as a protective shield preventing foreign particles and pathogens from entering the eye. Past the cornea lies the iris, the colored part of the eye responsible for regulating the amount of light that enters. The pupil is the small circular opening at the center of the iris. It controls the size of the aperture and the amount of light reaching the inner eye structures.

The lens sits behind the iris. It focuses light that enters the eye onto the retina at the back of the eye. These special neurons transform light into electrical signals and transmit the information to the brain for vision processing.

Several structures work together to lubricate the eye with tears. The tear gland produces tears to keep the eye moist and flush out any particles that irritate the eye. The eyelid connects to the eye by a group of muscle fibers. Aside from safeguarding the eye from damage, it distributes tears evenly across its surface for proper lubrication.

Difference Between Human and Dog Eye Anatomy

The anatomy of the dog's eye is quite different from the human eye. Dogs have a third eyelid called the nictitating membrane that's located below the lower eyelid in the inner corner of the eye. This eyelid appears opaque and works by sliding across the eye surface. As a result, when dogs sleep, their third eyelids cover their eyes, making it appear as though their eyes are wide open.

Aside from the third eyelid, dogs have two pairs of tear glands, the lacrimal glands and the nictitans glands, also known as the third eyelid glands. The nictitans gland secures up to 50% of the tear to lubricate the eye surfaces. Many people don't know it is also responsible for producing immunoglobulin to fight against infection. When these glands fail to function properly, bacteria and allergens have a bigger chance of entering the eye and causing infection.

What Causes Cherry Eye in Dogs?

Normally, a small ligament extends from the eye socket bone to anchor the nictitating membrane in its usual position. However, if the ligament weakens or breaks, the gland no longer has the support and falls out of its position. As a result, you see the gland popping above the edge of the third eyelid.

The exposed gland may look painful, but it only causes some discomfort. However, once the gland is no longer in the correct position, it fails to function properly. Consequently, the eye constantly suffers from dryness and irritation from bacteria and allergens.

Weak Connective Tissue in the Eye

Weakness in the connective ligament is often the cause of cherry eye. Most dogs that suffer from cherry eye begin developing the condition before one year old, while others usually show up between two to four years old. Other times, the weakening of the connective tissue has to do with inflammation, trauma, or other underlying medical conditions.

Genetics and Breed Predisposition

Although scientists are still trying to establish the exact cause of nictitans gland prolapse, they believe that genetics play a crucial role in the problem. Numerous historical correlation studies found that certain breeds have a predisposition to developing the ocular problem.

Dog Breeds Most Prone to Cherry Eye

Doctor of Veterinary Medicine S. Mazzucchelli and 10 other researchers conducted a retrospective study indicating that "five breeds were most commonly affected by the bilateral condition: French bulldog, Shar Pei, Great Dane, English bulldog, and Cane Corso." In general, flat-face breeds with brachycephalic skull conformation have a much higher risk of developing cherry eye than non-flat-face breeds.

Here are the other most commonly affected breeds:

• Neapolitan Mastiff: The Neopolitan mastiff is a large breed that is typically loyal and protective. They have a short, thick, and wrinkled coat requiring regular grooming. However, they are prone to some health conditions, including hip dysplasia, heart disease, and eyelid deformities.

• English Bulldog: The English bulldog is a medium-sized breed with a wrinkled face and muscular body. They are lovable, patient, and loyal, making them ideal companions for families with small children. However, they suffer from several heredity issues, including joint and respiratory problems and ocular and dental deformities due to their flat facial structures and compact bodies.

• American Cocker Spaniel: These cheerful and energetic dogs are famous for their long silky coats and doe-looking eyes. They are highly sociable and affectionate dogs that make excellent companion dogs. However, they often suffer from ear infections, eye problems, hip dysplasia, and heart disease.

• Basset Hound: The Basset hounds have the saddest droopy eyes among all dog breeds. They are also famous for their long ears, loose facial and neck skin, and short legs. Even though their original purpose was to flush out rabbits during hunting, these dogs are friendly and patient with small children. Aside from being prone to eye problems, they are also susceptible to ear infections and spinal problems.

• Beagle: These small, compact dogs always have their noses on the ground tracing for smells. They're energetic and playful. However, they often suffer from epilepsy, hip dysplasia, and ocular deformities.

• Boxer: These grumpy-looking dogs may look fierce and ready to fight, but they are loving, loyal, and patient with small children. They are also awesome service dogs that excel at guiding their owners and alerting them of oncoming epilepsy seizures. As with all flat-faced dogs, boxers are prone to cherry eyes and other ocular problems.

Breeding Practices and Cherry Eye Prevalence

While pure breeds have a higher risk than mixed breeds, Puggles are the exception to the rule. These findings suggest that the third eyelid gland prolapse gets passed along with other desirable traits during selective breeding.

Until scientists discover the exact mechanisms that cause cherry eye, the responsibility falls on breeders and responsible dog owners to ensure careful breeding practices and to avoid breeding dogs with a history of this condition.

Recognizing the Signs of Cherry Eye

Early detection is always easier to treat than when it causes other complications. There are several signs of cherry eye that all dog owners must know.

Bulging or Swelling of the Eye

As the tear gland prolapses, the bulge quickly becomes visible in the inner corner of the eye. This bulge may vary in size and appearance, resembling a reddish or pink tumor-looking mass.

Redness and Irritation

As the gland shifts from its original position, it may no longer provide sufficient moisture to the eye. As a result, the affected eye always appears red and irritated. When the tear gland becomes more exposed, it may become inflamed and irritated, leading to visible redness in the gland.

Discharge From the Affected Eye

Dogs with cherry eyes may also experience discharge from their affected eye. This discharge may be a clear liquid or thick and crusty, making it difficult for your dog to open their eyes. When the eye suffers from infection, the discharge may become yellowy, pus-looking. Pay attention to the color of the discharge, as your observation helps your vet identify the underlying cause of the issue.

Other Symptoms of Cherry Eye

Your dog may squint or constantly blink their eyes, leading to difficulty seeing and problems with balance. Depending on whether your dog paws at their affected eye, the constant irritation may cause redness around the eye.

Eye Conditions That Mimic Cherry Eye

Several eye conditions present similar symptoms to nictitans gland prolapse. They may be follicular conjunctivitis, eyelid infections, lacrimal duct obstruction, blepharitis (also known as inflammation of the eyelid), or even tumors.

Differentiating Cherry Eye From Other Ocular Disorders

Distinguishing cherry eye from other ocular disorders requires a professional evaluation, which includes a comprehensive examination of the affected eye and considerations from your dog's medical history, breed predisposition, parent history, and clinical presentation. Your vet may also perform a number of diagnostic tests, such as eye swabs or cultures, to rule out infections or other underlying causes.

Importance of Early Detection

Early detection and diagnosis are key to successful treatment and management of third eyelid gland prolapse. Delaying veterinary care may lead to potential complications, including chronic inflammation, infection, or even vision impairment. As a responsible dog owner, it is your responsibility to prioritize your furry friend's eye health and seek veterinary attention at the first sign of abnormalities.

Can Cherry Eye in Dogs Correct Itself?

Cherry eye in dogs does not typically correct itself without intervention. Once the ligament no longer holds the tear gland in place, it is highly unlikely that the ligament heals itself spontaneously.

In rare cases, the prolapsed tear gland may temporarily retract on its own, giving the appearance that the problem is alleviating. However, without appropriate treatment, the nictitans gland is likely to protrude again, leading to a recurrence of the condition.

Never Attempt Home Remedies

Nictitans gland prolapse is a structural issue involving the gland and its surrounding tissues. While some well-meaning individuals may offer home treatment or temporary self-correction techniques for your dog's cherry eye, they are generally ineffective and may worsen the condition.

Treatment Options

Many owners wonder if there are non-surgical approaches to treating nictitans gland prolapse. The answer is rarely. Only surgical treatment is effective in correcting the problem. The non-surgical approaches only help to alleviate the symptoms and prevent the eye from contracting infections.

Non-Surgical Approaches

If you discover that your dog is suffering from the early stages of cherry eye, non-surgical options may temporarily correct the problem, alleviate the symptoms, and prevent the ligament from deteriorating.

How To Treat Cherry Eye in Dogs Without Surgery

In less severe cases, your veterinarian may manipulate the prolapsed tear gland back into its original position within the eye. This method is effective in cases where the gland is still relatively mobile and the prolapse is not severe.

While the procedure may provide temporary relief, there is always a risk of recurrence. It is not a suitable approach if the condition is in more advanced stages or if there are other eye abnormalities.

Medication and Eye Drops

Some dogs may not experience a completely prolapsed tear gland. Instead of fixing a condition that may eventually stabilize, your vet may wait until the gland protrudes completely before opting for surgery.

In the meantime, they may prescribe eye drops, cherry eye dog ointment, or medication to lubricate the eye, alleviate irritation, and reduce the risk of infection and inflammation. All these treatments are only for managing the symptoms and potential risks.

Surgical Treatment Options

Surgery is usually the only method to treat the disorder properly. The corrective procedure is much more affordable than other surgical procedures that cost thousands of dollars. In 2023, the average cost to treat cherry eye in dogs varies between $300 and $1,500, depending on the severity and complication of the case. If you wonder if you should buy a dog with cherry eyes, the answer depends on whether you are willing to commit to all the extra eye care. After all, every dog deserves a loving home.

There are seven surgical replacement methods for correcting the prolapsed tear gland: gland excision, pocket technique (also known as imbrication), periosteal anchoring, interior scleral anchoring, tacking (also known as tucking), perilimbal pocket technique, and ventral rectus anchoring.

These methods work in three general ways of treating the problem:

• Cutting out the gland

• Fixing the gland without altering the third eyelid mobility

• Repairing the gland and the ligaments

Among all these methods, tucking and imbrication are the most popular options among veterinarians.

Tucking

Tucking is the most common surgical method for treating cherry eye. During this procedure, the vet uses a single stitch to anchor the gland back to its original position. Although this method is quick and easy to perform, the stitch often fails to secure the gland.

Sometimes, the stitch becomes undone and scratches the eye's surface. Under such circumstances, your dog needs immediate medical attention to remove the stitch from the eye.

Imbrication

Imbrication, often called pocketing, has recently gained popularity due to its higher success rate in correcting the disorder. Instead of using just stitches to anchor the tear gland, the vet cuts out a pocket in the original location. They then use small dissolving stitches to secure the gland as the pocket wound heals. Over time, the wound heals around the gland so that it remains in place.

Why You Should Never Remove the Prolapsed Gland

In earlier years, before veterinarians understood the importance of the tear gland, they recommended removing the prolapsed gland as the ultimate correction procedure. However, they quickly realized that after the procedure, the dogs suffered extremely dry eyes and easily contracted infections.

Today, the trend is to leave the gland in place and shift it back to its original location. If your vet recommends removing it, seek a second opinion from another professional, and discuss possible options for your pup.

Decision-Making Process for Treatment

When your veterinarian is considering procedure options to correct your dog's cherry eye, they usually factor in the severity of the condition, your dog's overall health and breed predisposition, and each option's potential risks and benefits.

For less severe cases of the prolapsed gland, your vet may opt for tucking. However, bigger breeds that have larger glands or droopy eye features may use the pocketing technique or even incorporate both techniques together for maximum success rate.

Post-Treatment Care and Management

Like all surgery procedures, post-treatment care and management are detrimental to the treatment outcome. As a result, your vet and their assistant usually give you specific instructions on how to care for your dog's eye.

Recovery Period and Healing Process

The recovery period varies depending on the treatment approach and your dog's response. At first, your dog's eye may appear red, and the eyelid may suffer from serious swelling. These two symptoms usually subside within two weeks after the surgery.

Caring for Your Post-Surgery Pup

During the initial healing process, closely following your veterinarian's instructions is essential. This includes administering prescribed medications and antibiotics to prevent infection and manage any residual inflammation.

Immediately after the procedure, minimize the time your pooch stays outdoors. Avoid using a leash on them, as the pressure on the neck may push out the gland from its position. If you need to take your dog out, consider using a body harness instead.

During the first couple weeks after surgery, your dog's eye may secrete slightly tan or gray discharge. Gently clean the eye area twice daily to prevent the discharge from gumming up your pup's eye.

While your dog heals, they may have the urge to paw at their eye or nudge it against home furniture. Monitor and stop this behavior as they may loosen the stitches or cause further inflammation. A buster collar usually helps prevent this problem from occurring.

Regular follow-up visits to the vet are a must throughout the healing process. Your veterinarian ensures that your pup is healing properly, and they may spot any infection early on before it causes any complications.

How to Prevent Cherry Eye

The more frequently your dog paws their eyes or rubs their faces against hard objects, the more likely they're going to develop the same problem again. At the same time, dogs that develop cherry eyes are more likely to experience the same problem in their other eye. To reduce the risk of recurrence, take these steps to keep your pup's eyes healthy.

Avoid Exposure to Irritants

Irritants like dust, smoke, or chemicals may contribute to eye irritation and inflammation. Take steps to minimize your pup's exposure to these irritants by keeping them away from smoke-filled areas.

Maintain a Clean Living Environment

Regular cleaning and dusting of your home reduces potential allergens and irritants that may affect your dog's eyes. Keeping your dog's bedding clean and dander-free also helps to prevent eye infections. When cleaning your home, always use pet-friendly cleaning products. Bleach and other harsh chemicals may produce fumes that irritate your pooch.

Protect Your Dog's Eyes During Outdoor Activities

If you love engaging in outdoor sports and activities with your pooch, consider getting them a pair of doggie shades. These sun goggles shield your dog's eyes from potential injuries, foreign objects, and excessive exposure to sunlight.

Regular Eye Care Routine

Establishing a daily eye care routine with your dog may alleviate dry eye and minimize infection risks. Gently clean their eyes with a vet-recommended eye solution. If you want to remove any stubborn discharge that accumulates around the eye, try using some warm saline solution to loosen the debris. After that, use a soft cloth or cotton ball to clean the area.

For dogs that suffer from dry eyes, applying a lubricating eye gel to their eyes before sleep may keep them more comfortable. It also prevents them from pawing their eyes or rubbing their heads against their beds.

Nutrition Support and Supplements

If your pooch has cherry eye, a balanced diet is vital for maintaining their overall eye health. Include foods rich in omega-3 fatty acids to help improve their tear production. It's a great idea to add other vitamin and mineral-rich foods that are high in beta-carotene and omega-6 fatty acids.

In addition to food, apply vitamin E, lutein, and zeaxanthin to your dog's diet. These supplements promote eye health by reducing inflammation and protecting the eyes against UV light damage. They also contain antioxidants that reduce eye dryness and irritation.

Potential Complications and Risks of Surgery

While surgical procedures for cherry eye have a 90% success rate, there are some potential risks and complications. These complications vary in severity and may require additional veterinary care.

Infection and Inflammation

Following surgery, there's always a risk of infection and inflammation at the surgical site. It usually occurs if the owner does not adhere to post-operation care and hygiene. If you detect any signs of inflammation, book an appointment with your vet as soon as possible.

Corneal Ulcers and Other Ocular Issues

Surgical intervention may sometimes result in corneal ulcers or other ocular complications. Studies find that puncturing the tear gland may drastically increase the risk of the dog suffering from dry eyes in the future.

It's important to monitor your dog's body language and see if they exhibit any signs of discomfort, excessive tearing, or unbalanced movement due to impaired vision. If you notice any abnormalities, seek immediate veterinary attention.

Recurrence of Cherry Eye

While surgical treatment aims to provide long-term resolution to the problem, there is up to a 20% possibility of recurrence. Here are several factors that contribute to the recurrence of cherry eye:

• The stitches fail to secure the gland position.

• Some breeds are genetically prone to cherry eye.

• Some have congenital disabilities that cause weak connective ligaments and eye connective tissue.

If your veterinarian exhausts all replacement options, or in rare cases where there is a tumor on the tear gland, then the only option is to surgically remove the gland. The removal is for the dog's overall health and well-being in such circumstances.

Take Action on Your Pup's Eye Health

Cherry eye in dogs is a common condition that requires prompt veterinary attention. While non-surgical approaches may manage or stabilize early stages, surgical intervention becomes necessary for more severe or persistent cases. By providing timely and appropriate treatment, you help ensure that your pup's eyes remain healthy and strong for years to come.

For more information about dogs, please refer to other articles on BarkSpot.