Cherry Eye or Prolapse of the Glands of the Third Eyelid

Filed Under: Dogs, Diseases

Have you suddenly noticed a red mass in the corner of your young dog’s eye? Are you concerned that there is a tumor in the corner of the eye when just a day ago everything looked normal? You could be dealing with a common problem in young dogs and puppies, especially in the cocker spaniel, commonly known as hyperplasia of the nictitans gland, “cherry eye”, or prolapse of the glands of the third eyelid.

The term "cherry eye" is a description of the swelling of the superficial lacrimal (tear) gland attached to the third eyelid or nictitating membrane. It becomes a swollen red mass and protrudes the margin of the eyelid. The term “cherry eye” comes from the prolapsed gland's resemblance to a cherry on the medial side of the eye (the area closest to the nose). The gland surrounds the base of the cartilage of the third eyelid and is responsible for a significant proportion of the serous and mucous tear production of the eye. When irritated and displaced the prolapsed gland will often will cause a secondary conjunctivitis (inflammation of the tissue surrounding the eye) and mucopurulent ocular (eye) discharge. Often the swelling of the gland will recede for short periods of time, especially when an eye ointment containing a steroid is used. Typically the gland will eventually reprolapse necessitating surgery.

The condition is actually caused by a laxity in the retinaculum that attaches the third eyelid to the periorbita fascia. The condition is seen clinically when a young puppy is exposed to environmental antigens for the first time, resulting in lymphoid hyperplasia of the gland attached to the third eyelid.

Two treatments, both surgical, have been used to correct cherry eye. In one surgery there is a partial removal of the gland. Gland removal, although simple and less expensive, is no longer the surgery of choice. Removal of the gland predisposes the pet to "dry eye" or keratoconjunctivitis sicca later in life. The superficial lacrimal gland has an important function in tear production. Tears are necessary to lubricate the eye and maintain clarity and the luster of the eye itself. Every time you blink your eye you are essentially lubricating it. It is estimated that up to 40% of dogs in which the gland has been removed will develop dry eye.

The preferred treatment is to reposition the gland surgically by anchoring it to the orbital rim of the eye. This surgery is more complicated and expensive but will preserve the tear production from the lacrimal gland, thereby preventing keratoconjunctivitis sicca. Recurrence is possible following surgery, especially when it occurs in large breeds of dogs.

It is common to see glands in both eyes prolapse since the cartilage weakness is believed to be heritable in beagles, basset hounds, bulldogs, cocker spaniels, boxers, bloodhounds, bulldogs, neapolitan mastiffs, shar-peis, Lhasa apsos, and the Pekingese. Cherry eye commonly occurs in the saluki, mastiff, komondor, and kuvasz but the genetics involved have not yet been unravelled and the cause to-date remains unknown. The condition is also seen and believed to be a heritable problem in the Burmese and Persian cat. Cherry eye may also occur secondary to trauma.

References:

Evans, Howard and George Christensen. Miller’s Anatomy of the Dog. W.B. Saunders Company. 1979. P. 1104.

Maggs, David. and Paul Miller et al. Slatter’s Fundamentals of Veterinary Opthalmology. 4th Edition. Saunders/Elsevier. 2008. Pp. 153-154.

Severin, Glenn. Severin’s Veterinary Ophthalmology Notes. 3rd Edition. Communications. Inc. 1995. P. 214.

Slatter, Douglas. Fundamentals of Veterinary Ophthalmology. 2nd Edition. W.B. Saunders Co. 1990. Pp.228-229.

Symptoms: eye inflammation, swollen eye

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