Introduction
Cats and dogs both have a nictitating membrane (also called a third eyelid) that normally functions to provide physical protection to the cornea and to produce a significant portion of moisturizing tear film. Prolapse of the gland associated with the third eyelid, commonly called “cherry eye,” is uncommon in cats but when it occurs should be treated as quickly as possible. “Cherry eye” is most commonly diagnosed in the Burmese and Persian feline breeds. The condition normally is not particularly dangerous to cats, but treatment is necessary to reduce the risk of more serious secondary ocular problems.
Treating “Cherry Eye” in Cats
Non-surgical options
“Cherry eye” can be treated medically with topical antibiotic and anti-inflammatory drugs and also through surgery. Topical therapy can help reduce the inflammation and possible infection commonly associated with this condition. However, this course of treatment is rarely successful permanently. If the prolapsed gland of the third eyelid does not resolve with medical treatment, surgical correction is the only viable treatment option. While repositioning the third eyelid back into place non-surgically is not a conventional treatment for “cherry eye” in cats, some veterinarians opt to try this before resorting to surgical repositioning. Repositioning the gland only takes a few minutes and apparently is painless for the cat. Unfortunately, like other non-surgical medical treatment, this technique typically is not a permanent solution, and the nictitating membrane tends to periodically re-prolapse.
Surgical options
At one time, surgical removal of the prolapsed portion of the third eyelid was the treatment of choice for “cherry eye.” However, as veterinary science discovered the importance of the third eyelid gland in tear production, surgical repositioning rather than removal became the treatment of choice. The gland of the nictitating membrane contributes up to 50% of the aqueous tear fluid, and removing it markedly increases the cat’s risk of developing so-called “dry eye” (keratoconjunctivitis sicca) as it ages. If the gland of the third eyelid is removed, the cat will require life-long treatment with moisturizing topical eye drops and anti-inflammatory medication to prevent severe and painful “dry eye.”
At least 8 different and successful surgical repositioning techniques have been reported, and the veterinarian will determine which to use in a given case. Some considerations include the ease of the procedure, its effect on future tear production, the chances of re-prolapse and the likely cosmetic results. While selection of a surgical technique is a matter of personal preference, all of the repositioning techniques, when performed properly, should result in a cosmetically acceptable outcome with a very low chance of recurrence.
If a cat has only one of its eyes affected by “cherry eye,” the owner should recognize that surgical correction of the affected eye will not reduce the risk of the condition developing in the other eye. Currently, there are no medical or surgical procedures available to prevent cherry eye in companion animals, and many animals will have to go through two separate surgeries to treat one eye at a time.
If you think that your cat has developed this disorder, try not to touch or manipulate the affected area. Do not try to reposition the third eyelid, as you may permanently damage the nictitating membrane or other critical components of your cat’s eye.