Goals of Treating Cherry Eye in Dogs
Prolapse of the gland of the nictitating membrane or third eyelid, commonly called “cherry eye,” should be treated as quickly as possible. The condition itself is not particularly dangerous to dogs, but correction is important to make the dog comfortable and reduce the risk of more serious secondary problems. The longer the that the third eyelid gland is out of place and exposed to environmental elements, the more inflamed, irritated and possibly infected it may become. The goals of treating cherry eye are to:
- Return the function and appearance of the third eyelid structures to as normal a state as possible
- Reduce abnormal discharge from the affected eye(s)
- Minimize irritation and injury to the corneal and conjunctival tissues
- Preserve and promote tear production from the gland of the third eyelid
- Reduce the risk of secondary bacterial infections
- Eliminate the dog’s discomfort
Cherry eye can be treated with topical antibiotics, anti-inflammatory drugs and surgery. Topical therapy can help reduce the inflammation and prevent or resolve the secondary infections that are commonly associated with the condition. However, topical treatments alone are rarely successful in curing cherry eye. In almost all cases, the prolapsed third eyelid gland will need to be repositioned surgically.
At one time, the treatment of choice for cherry eye was to remove the prolapsed gland of the third eyelid. However, removing the gland will cause the dog to suffer from severe dry eye, because that gland is responsible for much of normal tear-film production. Surgical excision of the third eyelid gland will greatly increase the dog’s risk of developing keratoconjunctivitis sicca (KCS), or “dry eye,” as it ages. If the gland of the third eyelid is removed, the dog will need to be treated several times daily with moisturizing eye drops for the rest of its life.
As veterinarians have learned more about the importance of the gland of the third eyelid in tear production, surgical repositioning rather than removal of that gland has become the treatment of choice for cherry eye. Many different surgical repositioning techniques have been reported, and each veterinarian will determine which technique to use in any given case. Some considerations include the ease of the procedure, its potential effect on future tear production, the chances of re-prolapse and the expected cosmetic results. While selection of the 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 dog has only one of its eyes affected by cherry eye, the owner should realize that surgical correction of the affected eye will not reduce the risk of cherry eye developing in the other eye. Currently, there are no medical or surgical procedures to prevent cherry eye in dogs. Many dogs will have to go through separate surgical procedures to correct cherry eye one eye at a time.
Surgical correction of cherry eye is usually very successful. Post-operatively, the affected eyes of most dogs will return to full normal function, as long as the affected gland is repositioned rather than removed. If the gland is removed, eye drops will be necessary to provide normal lubrication of the eye for the remainder of the dog’s life.