“With A Cherry on Top”
Lucy is a five month old female Cocker Spaniel who presented to the Route 516 Animal hospital for an acute abnormality with her right eye. Her eye was normal one minute but after roughhousing with a playmate, her owner noticed a pink structure protruding from the corner of her eye. She was concerned that Lucy’s eye might have been injured or was about to rupture. Upon examination, Lucy was a healthy normal puppy with the exception of dark pink tissue in the right eye’s medial canthus (the inner corner). Her diagnosis was a prolapsed third eyelid gland, often referred to as a “cherry eye”.
Dogs and cats differ from humans in that they have an extra, third eyelid which helps protect them during hunting or fighting. Contained in this lid is a gland which produces tears and tear film which keep the eye moist. It is this tear gland that is seen with the cherry eye condition. These gland prolapses can vary in size depending on the amount of tissue that prolapses and sometimes appear intermittently. They can occur unilaterally or in both eyes. Despite the alarming appearance cherry eye, it is not a painful condition.
Cherry eye is not typically caused by a traumatic event. It is due to a weak fibrous attachment which is common in many breeds. These include Cocker Spaniels, Bulldogs, Beagles, Bloodhounds, Lhasa apsos, Shih-tzus, and brachycephalic breeds (dogs with “squished faces”). Burmese and Persian cats are also predisposed. Lucy’s cherry eye was a result of her breed, not her playtime.
Treatment of cherry eye involves surgically replacing the third eyelid gland. In the past, this gland was removed. However, research has shown this gland creates 50 % of tears and removing it puts the patient at risk for KCS in the future. KCS is keratoconjunctivitus sicca, basically “dry eye”, and can result in substantial changes to cornea (the eye’s surface) and even result in blindness if left unmanaged. Therefore, it is important to keep the gland intact and attempt to surgically tuck it back into a pocket made in the third lid. The surgically replaced gland can function normally within a few weeks of surgery. However, up to 25% of cases will re-prolapse and require additional surgeries. Also, many pets that were affected unilaterally will have the other gland prolapse as well.
Lucy had the surgery to replace her cherry eye and went home with an E-collar (head lampshade) and triple antibiotic ointment. She has not had a reprolapse and her left eye continues to do well also. If you see pink tissue in the corner of your pet’s eye, call your veterinarian. If the lacrimal gland is still normal, it should be replaced, not removed.