Treatment Options
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 usually dangerous to dogs. However, effective treatment is necessary to reduce the risk of more serious secondary eye problems, including trauma to the cornea. The longer that the glandular tissue is out of place and exposed to the elements, the more inflamed, irritated, damaged and possibly infected it may become.
Cherry eye in dogs can be treated with topical antibiotic and anti-inflammatory medications and through surgery. Topical therapy can help to reduce the inflammation and irritation commonly associated with this condition. Unfortunately, this course of treatment is rarely successful in preventing recurrence of cherry eye in the long run. In most cases, surgical correction is the only viable permanent treatment option.
At one time, surgical removal of the prolapsed portion of the tear gland associated with the affected third eyelid was the treatment of choice. However, removing the tear gland greatly reduces normal tear production, contributing to severe dry eye and greatly increasing the animal’s risk of developing a disorder known as keratoconjunctivitis sicca (KCS) as it ages. If the gland of the third eyelid is surgically removed, the dog will probably need daily supplementary treatment with moisturizing eye drops for the rest of its life.
Prognosis
As veterinary science has learned more and more about the importance of the gland of the nictitating membrane in tear production, surgical repositioning rather than removal of that tear gland has become the treatment of choice for dogs with cherry eye. At least 8 different surgical repositioning techniques have been reported, and more are being considered. The dog’s veterinarian will determine which technique to use in a given case. Some pertinent considerations may include the dog’s facial structure, the ease of the procedure, its effect on future tear production, the chances of recurring third eyelid gland prolapse and the likely cosmetic outcome of the operation. 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 for owners, with a very low chance of recurrence of the condition.
If a dog has only one of its eyes affected by cherry eye, surgical correction of the affected eye will not reduce the risk of prolapse of the tear gland of the third eyelid in the other eye. It is not unusual for a dog to have to go through two separate surgical procedures in order to correct one eye at a time.