Canine Third-Eyelid Gland Prolapse (Cherry Eye): What to Do

1 What Causes the Prolapse

The nictitating-membrane gland sits beneath the inner corner of the eye and is richly supplied with blood vessels. Mechanical injury, secondary or concurrent infection, and other irritants cause the gland to oversecrete and enlarge. When the gland’s duct becomes blocked by inflammatory debris or foreign material, the gland swells until it extends beyond the free edge of the membrane, producing a localized protrusion.

2 Signs and Progression

Early on, the third eyelid becomes swollen from infection, the conjunctiva turns red, and tearing develops. As the condition advances, a pink, fleshy tumor appears at the inner corner of the lower eyelid; it may affect both eyes at once. Growth is rapid, usually reaching pea size within 3 to 7 days, typically in one eye first and the other soon after, although sometimes only one eye is involved.

During the illness the conjunctiva is red and tearing (tears wet the fur and leave stains), with obvious ocular inflammation and discomfort. Discharge increases noticeably, and the dog often scratches the eye with a front paw, which can mechanically damage the cornea or worsen the inflammation. In late stages a purulent discharge appears.

3 Surgical Removal

Disinfect the eye with 0.1% benzalkonium chloride or 1% boric acid and apply local anesthesia. Use a surgical hook or hemostat to grasp the hypertrophic gland and gently pull it outward so the gland and the shape of the third eyelid are fully exposed. Then clamp the base of the gland at its junction with the third eyelid using a hemostat, taking great care not to injure the third eyelid and ensuring the blood vessels are firmly clamped.

An assistant uses surgical scissors to cut away the hypertrophic gland flush against the hemostat, then holds the hemostat in place for at least 5 minutes to achieve hemostasis before releasing it. If bleeding is excessive, continue clamping until it stops. After releasing, apply 2 to 3 drops of chloramphenicol eye drops to prevent infection. The patient can be reversed with atipamezole injection at 0.1 to 0.15 ml/kg by intramuscular or intravenous route as appropriate.

4 Post-Operative Care

After surgery, use chloramphenicol eye drops combined with hydrocortisone eye drops for anti-infective treatment: 1 to 3 drops each time, 3 to 4 times daily, for one week.