Goals of Treating Cherry Eye in Cats
Prolapse of the gland of the third eyelid (the nictitating membrane), commonly called “cherry eye,” should be treated as quickly as possible. The condition is not particularly dangerous, but correction is important to make the cat comfortable and reduce the risk of more serious secondary eye problems. The longer that the gland remains out of place exposed to environmental elements, the more likely it is to become irritated, inflamed, dry and possibly infected. The goals of treating cherry eye in cats are to:
- Return the function and appearance of the third eyelid and related structures to as normal a state as possible
- Reduce abnormal discharge from affected eye(s)
- Minimize irritation and injury to the cornea and conjunctiva
- Preserve and promote tear production
- Reduce the risk of secondary bacterial infections
- Eliminate discomfort
Treatment Options for Cats with Cherry Eye
Cherry eye can be treated with drugs, manual manipulation and/or surgery. Topical and oral medications can relieve discomfort, reduce inflammation and prevent or resolve the secondary bacterial eye infections that commonly accompany this condition. However, drug treatments alone rarely resolve cherry eye permanently. Some veterinarians try to reposition the third eyelid back into place manually before resorting to surgery, although this isn’t a conventional treatment. Manual manipulation of the gland only takes a few minutes and apparently is painless. Unfortunately, this technique typically doesn’t provide a permanent solution.
In most cases, cherry eye needs to be corrected surgically. At one time, the treatment of choice was to remove the prolapsed gland. However, because the third eyelid gland is responsible for producing a large part of the tear fluid, removing it markedly increases a cat’s risk of developing chronic “dry eye” (keratoconjunctivitis sicca) as it ages. Those cats will require life-long daily treatment with topical eye drops and anti-inflammatory medication to keep their eyes moisturized and pain-free. Today, most veterinarians recommend surgically repositioning rather than removing the third eyelid gland in animals with cherry eye. There are several different repositioning techniques, each of which should result in a cosmetically acceptable outcome with a low chance of recurrence if performed properly. Some considerations are the ease of the procedure, its potential effect on future tear production, the chances of re-prolapse and the expected cosmetic results. Surgical correction of one eye won’t reduce the risk of cherry eye developing in the other.
If you think that your cat has cherry eye, try not to touch or manipulate the protruding red tissue mass. Also, don’t try to reposition the third eyelid, because it is possible that you might cause permanent damage to it or to other associated eye structures.