Our canine friends have three eyelids as opposed to the two that we have. Broadly, the function of the third eyelid and third eyelid gland is to provide protection and lubrication to the eyes. Here’s how they work: the gland in the third eyelid, also called the nictitans gland or the accessory lacrimal gland, produces 30-50% of the tears in dogs (the rest of the tears come from lacrimal glands or tear glands near the top eyelid). The third eyelid, also called the nictitating membrane, spreads these tears - made of water, oil and mucus - over the eyes to lubricate them.

Normally, the third eyelid gland is hidden from view. Cherry eye occurs when the fibrous membranes holding the nictitans in place (tethered to the lower rim of the eye) are congenitally weak. This can cause the third eyelid gland to prolapse or move outwards (pop out) and appear like a bump in the lower corner of the eye. Because of how it looks, the condition is colloquially known as cherry eye. Typically, dogs do not experience pain as a result of cherry eye.

Cherry eye is mostly seen in younger dogs (below two years of age), and small- to medium-breed dogs. Cocker Spaniels, Beagles, Bulldogs, Lhasa Apsos, Shih Tzus are some examples of breeds that are most likely to be affected by the condition. Treatment for cherry eye usually involves surgery. If left untreated, the condition can cause dry eyes in mild cases and permanent eye damage in severe cases.

  1. Signs and symptoms of cherry eye in dogs
  2. Cherry eye causes and risk factors
  3. Diagnosis of prolapsed eyelid gland in dogs
  4. Dog cherry eye treatment
  5. After-surgery care: precautions and potential complications

Cherry eye looks like a red bump protruding from the lower eyelid. It may look like a tiny bump or it may be large and cover a big part of the eye. In either situation, it is important to take your dog to a veterinarian as soon as possible. Delay in treatment can cause serious harm to your dog’s eyesight.

Either one or both the eyes can have prolapsed third eyelid glands.

Remember that the third eyelid gland is not visible at all under normal circumstances. If you notice redness and protrusion in the bottom part of your dog’s eye, it is a good idea to get it checked out by a doctor.

The exact cause of cherry eye in dogs is not known. The likely explanation is that certain genetic traits make the fibres holding the third eyelid weaker, but it is not known whether it is an inherited condition. 

Smaller dog breeds, including Beagles, English Bulldogs and French Bulldogs, are more prone to this condition.

Another feature of cherry eye is that if it happens once, there is a likelihood that it may happen again. Chances of recurrence are high. Surgery is considered to be the best treatment option, but relapse can occur even after surgery.

If your dog’s eyes look inflamed, it is a good idea to visit the vet. Identifying an issue early on always leads to a better prognosis. If an infection is causing the redness, then prompt management will help to avoid complications.

Though cherry eye is not painful for most dogs, it can lead to other problems. For example, once the third eyelid moves away from its resting place, it can get inflamed due to constant motion and exposure to the elements. This makes early diagnosis and treatment doubly important.

To make a diagnosis, your vet will want to conduct a thorough overall checkup.

  • If there are accompanying symptoms or changes in behaviour, tell the doctor about these.
  • If it is a clear cut case of cherry eyes, imaging and blood tests are generally not required. Examining the eye and identifying the inflamed eyelid is sufficient to make a diagnosis.
  • However, your doctor may investigate accompanying conditions, such as conjunctivitis.

Sometimes, cherry eyes don’t have consequences beyond cosmetic ones. But if there is degeneration of the eyelid, then it may cause dry eyes and increase the likelihood of eye infections in the future.

The courses of treatment can range from applying a warm compress to the eye to surgery. However, it is important to take your dog to the vet and only try the remedies suggested by him/her. Remember, delay in proper treatment can cause permanent damage to your dog’s eyes!

Some of the treatments for cherry eye that your doctor might recommend are:

  • Applying a warm compress to the area and gently massaging it. This relaxes the swelling to an extent and the gentle pressure repositions the eyelid. Sometimes this method does work, but the caveat is that there is a likelihood of recurrence: dogs may appear normal for days or weeks, but since the underlying cause has not been addressed, the prolapse might recur.
  • The vet may also prescribe some topical antibiotics to ward off local infections. 
  • Surgery is the most commonly employed intervention. There are at least two different kinds of surgery for cherry eye in dogs: tucking and imbrication.
  • During tucking, the eyelid is readjusted and a stitch anchors it to the cartilage. While the surgery itself is not risky, there is a chance of relapse. Clinical evidence suggests that the surgery may need to be repeated twice or even thrice in case of recurrences. 
  • A method called imbrication involves removing a part of the gland. Sutures are embedded in the newly created dent to provide extra support. As with tucking, there is a chance of relapse. Veterinary surgeons may try these interventions together to improve the prognosis.
  • Removal of the third eyelid is the option of last resort. If all else fails, then this drastic step is taken. However, this can impair the normal functioning of the eye: Since the nictitans glands produce a sizeable amount of water for the eye, their absence increases the likelihood of keratoconjunctivitis (dry eye) in dogs. This will pave the way for further infections.
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Surgery is considered the best treatment option for treating cherry eye in dogs. However, there are some complications that can occur due to eye surgery. Here are some of the things to look out for:

  • Tucking involves holding the third eyelid gland in place with the help of a permanent stitch. If this stitch becomes undone, it can scratch the eye - causing pain and redness.
  • If your dog has a recurring cherry eye problem, then tucking may not be enough to hold the gland in place - talk to your doctor about the possibility of imbrication or a combination of imbrication and tucking surgery for your dog.
  • If your dog has had imbrication for cherry eye, then there may be some inflammation and swelling as your dog heals. Try to make him/her as comfortable as possible. Visit your doctor if the swelling does not come down in about a week or if your dog is in pain.
  • If your dog has any other eye conditions in addition to cherry eye, then surgery may be more difficult. Share your pet's entire medical history with your doctor, so he/she can recommend the correct course of action.
  • If your doctor has recommended antibiotics, make sure you give them regularly as per the prescription.
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