"Cherry
Eye" is the common name used to identify a prolapse of the gland of the third eyelid.
This third eyelid is located in the inside corner of each eye. The medical
term for Cherry Eye is Nictitans Gland Prolapse. Prolapse of the gland means
that the gland comes out of its normal position and protrudes from the eye.
When this happens, the gland appears as a visible pink/red bulge in the
corner of the eye. While unsightly, this occurrence is not an emergency and
you shouldn't get overly stressed about getting immediate veterinary care in
the middle of the night or over a weekend. It can be annoying to the dog if
left untreated for any length of time, but it's not necessarily painful and
can wait a day or two for treatment if necessary.
Keep
in mind however, that once exposed to dry air and irritants, the gland can
become further irritated, red and swollen, so treatment shouldn't be put off
indefinitely. If left untreated for more than a day or two, a mucous
discharge and redness of the conjunctiva (lining of the eyelid) may develop
and if the animal rubs or scratches at its eye, the gland could be further
traumatized, causing increased swelling and irritation. Trauma to the gland
from prolonged prolapse or from the dog rubbing or scratching could also injure the eye itself,
leading to an ulcer on the surface of the eye.
While any dog can develop Cherry Eye, this is a condition which is more
common in breeds that have large or protruding eyes or eyelid construction
that is not tight and tends to droop - Cocker Spaniels, English Bulldogs,
Shih Tzus, Lhasa Apsos, Bloodhounds, etc. It is is most common in young
dogs, six weeks to two years of age and appears equally in males and
females. Cherry Eye can occur in one or both eyes and may occur in each eye
at different times.
A C.E.R.F. certificate or clear ophthalmologist eye exam on a particular dog
does not mean that that particular dog does not have or has never had Cherry
Eye. Nor does a clear exam mean that puppies from that dog will never
develop Cherry Eye. Cherry Eye has not been proven to be a genetic defect
and C.E.R.F. will certify a dog that has had one or both glands prolapsed.
The
reason this prolapse occurs is not completely understood. It can
occur secondary to eye inflammation or irritation or for unknown reasons.
Some people suspect that certain occurrences may be due to a genetic
weakness of the connective tissue that attaches the gland to the surrounding
structures of the eye. However,
there is no known inheritance pattern for Cherry Eye.
While I have seen some familial tendency with Cherry Eye, I have also
seen
numerous instances that occurred shortly after a particular dog had been in a
stressful situation (new home, first dog show, trip to the groomer's, etc.).
If
you suspect your dog has Cherry Eye, you should contact your veterinarian as
soon as possible to avoid further complications. Your vet will visually
inspect both eyes and may measure tear production or do a fluorescein
staining of the cornea to be sure there is no other problem contributing to
or as a result of the Cherry Eye development. Depending on what your
vet finds on examining your dog, there are several courses of action for
treating this condition.
Most vets prefer to start treatment by trying a round of antibiotics
and/or topical anti-inflammatory medications to decrease inflammation of the
conjunctiva and the prolapsed gland. If
this treatment is ineffective, your vet will most likely suggest a minor
surgical procedure be done to correct the problem. There are two different
surgical procedures to choose from and each has its pros and cons. The
preferred procedure (at this time) involves "tacking" the prolapsed gland
back in position with a suture that attaches the gland to the deeper
structures of the eye socket. The second procedure is to completely remove
the gland.
The
current preference for repositioning the gland stems from the fact that the
third eyelid contains a tear duct which is responsible for as much as 35% of
watery tears in the eye. It is believed that removal of the gland may
contribute to a dog developing a condition known as Dry Eye (Keratoconjunctivitis
Sicca or KCS) later in life. When the third eyelid gland is removed, you may
be increasing the chances for the development of this condition, especially
if the dog should suffer from another condition or injury that impacts the
production of tears from the remaining tear glands. Dry Eye can require
daily treatment to the eye with artificial tears and lubricants. Signs of
dry eye can include thick, pussy discharge, redness of the conjunctiva and
cloudiness of the cornea.
If
your dog only has one eye that has prolapsed, you should watch the other eye
closely for development of a Cherry Eye as it is likely to prolapse as
well. If you choose to have a prolapsed gland repositioned and tacked down,
you can ask the vet to suture the other eye's gland at the same time. This
could help prevent the need for a second surgery.
The success of surgery to replace a prolapsed gland will be affected by
the size of the gland at the time of surgery, the length of time the gland
was prolapsed, and the condition of the cartilage of the third eyelid.
Generally
speaking, the success rate is higher if the gland is replaced quickly.
Excessive swelling or inflammation or damage to the cartilage can all impact
whether surgical replacement is successful. You can generally consider
surgical replacement to have been successful if the gland stays in place for
30 days after being tacked back into position. If a repositioned gland
should prolapse a second time, a second surgical replacement can be
attempted or you and your vet may choose to remove the gland completely.
Surgical
treatment of Cherry Eye is generally very quick, relatively inexpensive and
has few complications. The gland is either replaced or is completely absent
and causes no further problem. It will be important that you administer all
medication and that you return for any follow-up care as directed by your
veterinarian. In some dogs, an Elizabethan collar may be needed after
surgery to prevent self-induced injury while the surgery site heals. Most
dogs will be given an antibiotic ointment for treatment of the eye for a few
days after the surgery, but this is generally the only follow-up care
necessary.
The treatment may
seem straightforward as described above but, in my experience, there are
several additional facts that need to be considered when deciding how to
treat a case of Cherry Eye. Remember, the following information is based on
my own personal experiences and my viewpoint is offered for informational
purposes only! I am not a vet and you should always consult your own
veterinarian for diagnosis and treatment of any problem with your dog.
In my years of dealing with Cockers, here is what I have seen when dealing
with this condition and how I deal with this occurrence in my own dogs:
- In my experience, topical and/or injectable treatments of antibiotics and/or corticosteroids
are most often ineffective in reducing the gland and, even if they do work,
the gland is likely to prolapse again at a later date.
- Since a prolapsed gland is at risk for further trauma or infection, I
believe prompt surgical treatment is the best choice.
- Every dog that I have had the gland repositioned and "tacked" down,
prolapsed again at a later date and had to have additional surgery to
correct the problem. Most vets will tell you there is only a 5 to 20 percent
recurrence rate. I have seen much higher percentages in my own and other's
dogs.
- 9 times out of 10, if one eye prolapses, the other will too. The second eye
usually prolapses within 1-4 weeks of the first. Or as soon as I do surgery,
the second eye will prolapse so that I have to have a second surgery almost
immediately following the first!
- If I have a dog
that develops Cherry Eye, I have it surgically removed. I feel that prompt
removal without the need for additional surgeries and treatment is safest
for the dog.
- I have had numerous Cherry Eyes completely removed over the years and I have
never had a dog develop Dry Eye.
- I have seen some familial tendency in the occurrence of this problem, but I
don't actually believe this is the result of a specific gene that is
"defective". I believe that changes in head structure in American
Cockers over the last 70 years (shorter noses, more pronounced "stops", more
prominent eyes) have contributed to an eye structure that is now more
susceptible and sensitive to irritation and contaminants (dust, dirt, hair) getting in the
eye and/or to trauma. I further believe that these structural changes have resulted in
certain head "types" which are more prone to this problem.
- In my experience, if
you hope to avoid this issue when purchasing a puppy, you should choose a
dog with the tightest eye rims possible. Dogs with droopy
lower eyelids (which catch and hold more contaminants in the eye and which
do not help support the interior eye structures) tend to be more
susceptible to this problem.
If you choose to purchase a Cocker Spaniel, there is some chance that you
may eventually have to deal with Cherry Eye. Reputable Cocker breeders as a
whole are working to find a way to eliminate this problem, but it is a
problem that is prevalent in the breed and can crop up in any bloodline.
for
further information on Cocker Spaniels.
