Cherry Eye

Cherry eye is usually straightforward to identify, though severity and secondary changes vary:

• A smooth, rounded, pink or red oval mass visible in the inner corner of one or both eyes — the hallmark sign
• Increased eye discharge or tear staining around the eye
• The eye may appear red, irritated, or watery
• Occasional pawing at the eye if the exposed gland becomes inflamed or ulcerated
• The gland may intermittently slip back on its own early in the course of disease, making it appear to come and go
• If the condition has been present for weeks to months, signs of concurrent dry eye — thick, ropy discharge, dull or hazy cornea — may be present

Cherry eye results from weakness or failure of the connective tissue that anchors the third-eyelid gland in its correct position. Contributing factors include:

• Breed predisposition — the condition is strongly breed-linked, suggesting an inherited anatomical vulnerability. Most commonly affected: Bulldogs (English and French), Beagles, Cocker Spaniels, Basset Hounds, Shar-Peis, Lhasa Apsos, Boston Terriers, Shih Tzus, and Bloodhounds. Persian and Burmese cats are the most commonly affected feline breeds
• Young age — the majority of cases occur in dogs under two years of age, when the supporting tissues are still maturing
• Bilateral risk — if one eye is affected, the other has an elevated chance of developing cherry eye; roughly 40–50% of cases eventually involve both eyes

There is no known way to prevent cherry eye in predisposed breeds, since the underlying ligament weakness is structural rather than injury-related.

Diagnosis of cherry eye itself is visual — the prolapsed gland is obvious on examination. The more important diagnostic step is assessing what has happened as a result of the prolapse:

• Schirmer tear test measures tear production; prolonged cherry eye can impair the gland's output, leading to reduced tear scores that indicate subclinical dry eye even before symptoms appear
• Fluorescein staining checks whether corneal ulcers or abrasions have developed from the irritation
• Intraocular pressure measurement if concurrent eye redness or cloudiness suggests a secondary problem

Early cases with a healthy gland have the best surgical outcomes, so prompt evaluation is worth prioritizing.

The definitive treatment for cherry eye is surgical repositioning of the prolapsed gland — not removal. Historically, some veterinarians simply excised the gland, but this increases the lifetime risk of dry eye significantly and is no longer considered the appropriate standard of care except in rare circumstances.

• Pocket technique (imbrication/tacking) — the most widely used approach; the gland is tucked back into a surgically created pocket in the third eyelid and secured. Preserves the gland and its tear-producing function
• Anchoring suture technique — the gland is sutured to the periorbita (tissue near the orbit) to hold it in position; used in some anatomies or when the pocket technique isn't feasible

Temporary topical anti-inflammatory drops may reduce swelling before surgery in severely inflamed glands, but drops alone do not permanently reposition the gland. Recurrence after surgery occurs in a small percentage of cases and may require a second procedure. If significant dry eye is present, ongoing KCS management with cyclosporine drops is added alongside surgical correction.

Cherry eye does not resolve on its own, and each week the gland remains exposed increases the risk of permanent damage to its tissue and function. If you notice a red mass in the corner of your pet's eye, schedule an evaluation promptly rather than waiting. Owners of predisposed breeds — especially young Bulldogs, Beagles, and Cocker Spaniels — should know the signs so they can act quickly. The team at Dog & Cat Hospital Calabasas can confirm the diagnosis, assess tear production, and plan the surgical correction that gives the gland the best chance of a lifetime of healthy function. Book an appointment today.