Cherry Eye Repair

Cherry eye does not resolve on its own — the gland will not return to its pocket without surgery. Delaying treatment allows the exposed gland to become increasingly inflamed and reduces its long-term function. More importantly, this gland accounts for roughly 30–50% of the eye's total tear production; removing it (as was common in older practice) significantly increases the lifetime risk of dry eye disease. Modern surgical repair preserves the gland by repositioning it, which is why replacement rather than removal is now the strongly preferred approach. Surgery is recommended as soon as the prolapse is identified, before chronic inflammation sets in.

Cherry eye repair is performed under general anesthesia with the eye lubricated and protected throughout. The most common technique is the pocket (envelope) method:

• Small incisions are made in the conjunctival tissue above and below the prolapsed gland, creating a pocket
• The gland is tucked into the pocket and the incisions are closed with fine absorbable sutures, securing the gland in its normal position beneath the third eyelid
• No tissue is removed — the entire gland is preserved

Alternative techniques include a purse-string suture anchoring the gland or a combination approach in severe or recurrent cases. The surgeon selects the technique based on the degree of prolapse and gland condition. Both eyes may be addressed at the same time if prolapse is present bilaterally.

A full ophthalmic examination is performed before surgery to assess gland health, rule out concurrent eye conditions, and evaluate whether any corneal irritation has developed from the prolapse. Pre-anesthetic bloodwork is run, particularly in animals with health conditions. Anti-inflammatory eye drops may be prescribed in the days before surgery to reduce gland swelling and improve the repair. Food is withheld the night before the procedure.

Cherry eye repair is typically an outpatient procedure with a smooth recovery:

• Days 1–7: e-collar worn to prevent rubbing; prescribed anti-inflammatory and antibiotic eye drops administered as directed
• Week 1–2: mild swelling in the inner corner of the eye is normal and resolves within one to two weeks
• 2–4 weeks: recheck exam confirms the gland is staying in place and the eye looks healthy

Reprolapse (the gland popping back out) can occur in a small percentage of cases, especially in highly predisposed breeds. If it happens, revision surgery is performed promptly. Breeds with very loose eyelid conformation — Bulldogs, Cocker Spaniels, Beagles, Basset Hounds, Shar-Peis — have higher rates of reprolapse than others.

Cherry eye repair has a good success rate, particularly when performed before the gland has been exposed and inflamed for a long time. The main risk is reprolapse, which occurs more frequently in brachycephalic (flat-faced) breeds and large-breed dogs. Revision surgery, sometimes using a different technique, addresses reprolapse effectively in most cases. Infection is uncommon, and the sutures used are absorbable so they do not need to be removed. Lifelong monitoring of tear production (Schirmer tear test) at wellness visits is recommended in breeds predisposed to dry eye, regardless of whether cherry eye surgery was performed.