Cherry Eye

13.cherry-eye-300x214Cherry Eye is the common name for a prolapse of the third eyelid gland.  It is most often caused by a heritable weakness of the connective tissue that holds the gland under the third eyelid of the eye.  Cherry eye is common in smaller breeds under 12 months old.  The everted tissue protrudes from the inside corner of the eye and becomes red and inflamed because of environmental irritation and desiccation (drying) of the exposed gland.  Secondary infection as a result of the prolapse may cause a mucousy film or discharge from the affected eye.  Treatment with anti-inflammatory eye medications may sometimes decrease the swelling, but does not eliminate the cherry eye.  Surgery is needed to correct the prolapse and retain normal tear production.  Pets with cherry eye will very often develop the problem in both eyes.

There are two basic approaches to cherry eye surgery.  The first is a cosmetic surgery and has fallen out of favor in recent years because of increased incidence of complications that may arise years after the procedure.  This technique involves removing the entire gland from the third eyelid.  Breeds that are prone to cherry eye are also more likely to develop dry eye (KCS) later in life.  By removing one of only two tear glands in the eye, the pet becomes even more susceptible to KCS as it ages.  KCS causes significant damage to the eye, so preservation of the gland is preferred.  There are two variations of the second approach, but both involve preservation of the third eyelid gland.  A permanent suture can be placed to tuck the gland where it belongs.  Complications are uncommon but do occur.  The suture may come undone and scratch the cornea, and the prolapse may recur, making a second surgery necessary.  The newest technique is the most tedious but is recommended by most board-certified ophthalmologists.  This surgery removes a wedge of tissue in the third eyelid, creating a pocket in which to tuck the gland.  The pocket is sutured closed with tiny absorbable sutures.  As the incision heals, the margins tighten and pull the gland back into place.  This technique, while superior, also sometimes fails requiring a second surgery.

Post-operative swelling is expected after any eye surgery.  An Elizabethan collar is placed around the patient’s neck to prevent rubbing and scratching at the eye.  Antibiotic ointment is often prescribed after cherry eye surgery to prevent secondary infection.  It is very likely that a pet with a cherry eye will develop one in the other eye.