Cherry Eye [Prolapsed Gland of the Nictitans]
Learn what the condition is, how it may be detected early, how it is treated or managed, and which breeds or species are linked to it.
Condition snapshot
A concise guide to the condition’s pattern, detection, management and urgency.
This snapshot is a general guide, not a diagnosis or treatment plan. New, severe or worsening signs require veterinary assessment.
About the condition
Cherry eye is the common name for prolapse of the tear-producing gland associated with the third eyelid, or nictitating membrane. This gland normally sits out of sight at the inner corner of the eye and contributes a substantial proportion of the eye’s tear production. When the supporting tissues are too loose to hold it in position, the gland can rise over the edge of the third eyelid and appear as a rounded pink or red swelling.
The condition is seen most often in young dogs and has strong breed associations, although the exact inheritance pattern has not been fully defined. It may affect one eye initially and later appear in the other. The exposed gland becomes irritated and swollen because it is no longer protected in its normal position. Some dogs rub at the eye or develop discharge, while others seem relatively comfortable despite the obvious swelling.
Cherry eye itself does not usually cause immediate loss of vision, but the gland is important for long-term ocular health. Chronic exposure can lead to inflammation and damage, reducing its ability to produce tears. Historically, prolapsed glands were sometimes removed. This is now generally avoided because removing tear-producing tissue increases the risk of keratoconjunctivitis sicca, or dry eye, later in life. Dry eye can be painful and may cause chronic discharge, corneal ulceration, scarring and visual impairment.
Prompt attention is preferable to leaving the tissue prolapsed for long periods. The aim is not simply to improve appearance; preserving a functional tear gland reduces the chance of significant future eye disease.
Prolapse is particularly common during puppyhood and young adulthood in predisposed breeds. Manual replacement may occasionally return the gland temporarily, yet recurrence is common because the underlying anatomy remains unchanged.
Screening & Early Detection
Cherry eye cannot be predicted reliably in a normal puppy using a genetic, blood or imaging test. Early detection is visual. Owners and breeders should become familiar with the normal smooth contour of the inner corner of the eye and seek veterinary assessment if a pink or red rounded mass suddenly becomes visible.
A veterinary examination confirms that the swelling is the gland of the third eyelid rather than another conjunctival mass or inflammatory problem. The eye should also be checked for corneal irritation, discharge and secondary inflammation. Tear production may be measured, especially when the gland has been prolapsed for some time, both to assess current function and to provide a baseline for future monitoring.
If one eye is affected, the opposite eye should also be observed because bilateral disease is common in predisposed dogs. Recurrent episodes in which the gland temporarily returns to position should still be discussed with a veterinarian; repeated prolapse indicates that the supporting tissue is inadequate. Squinting, marked pain, a cloudy cornea or thick discharge suggests additional eye disease and should be assessed promptly rather than assuming every sign is caused by uncomplicated cherry eye.
Diagnosis is usually straightforward from the appearance and location of the prolapsed gland, although the veterinarian should also examine the cornea and assess the rest of the eye.
Treatment & Management
The preferred treatment for persistent cherry eye is surgical replacement of the gland into a position where it can continue producing tears. Several techniques are used, most commonly creating a small pocket of tissue to secure the gland or anchoring it in place. The objective is to preserve the gland, not remove it. Surgery is often recommended before prolonged exposure causes chronic inflammation and damage.
Short-term lubricating or anti-inflammatory eye medication may reduce irritation while surgery is being planned, but medication does not correct the loose support that allowed the gland to prolapse.
After surgery, dogs usually need topical medication, protection from rubbing and reduced rough activity while the tissues heal. The gland can reprolapse in some cases and a second procedure may be required. Tear production should be monitored over time, particularly if the gland was severely inflamed before treatment or if both eyes have been affected.
Removal of the gland is generally avoided because it sacrifices an important source of tears and can predispose the dog to chronic dry eye. If tear production later becomes inadequate, lifelong treatment with tear-stimulating and lubricating medications may be necessary. Prompt surgical preservation therefore offers both a cosmetic improvement and, more importantly, protection of the eye’s normal tear film and corneal health.
Breeds or species affected
American Cocker Spaniel
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Basset hound
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Beagle
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Bloodhound
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Boston terrier
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Boxer
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British Bulldog
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Bull terrier
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Shar Pei
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German shorthaired pointer
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Irish setter
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Lhasa apso
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Miniature Poodle
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Neapolitan mastiff
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Newfoundland
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St Bernard
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Shih tzu
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Weimaraner
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