Cherry Eye in Dogs: Causes, Symptoms, and Effective Treatment Options
Cherry eye, a common ailment affecting dogs, can be a concerning sight for pet owners. It’s characterized by a red, fleshy bulge protruding from the corner of the eye, resembling a cherry. While not typically life-threatening, it can cause discomfort, irritation, and potentially lead to more serious complications if left untreated. This comprehensive guide delves into the causes, symptoms, diagnosis, and treatment options for cherry eye in dogs, providing you with the knowledge you need to ensure your furry friend’s well-being.
Understanding Cherry Eye: What Exactly Is It?
To fully grasp cherry eye, it’s essential to understand the anatomy of a dog’s eye. Dogs, like humans, have three eyelids: an upper, a lower, and a third eyelid, also known as the nictitating membrane. This third eyelid, located in the inner corner of the eye, plays a crucial role in protecting the cornea (the clear outer layer of the eye) and producing a significant portion of the dog’s tear film. Within this third eyelid resides a tear-producing gland. Cherry eye occurs when this gland prolapses or pops out of its normal position.
This prolapse happens when the connective tissue that anchors the gland in place weakens or breaks down. As a result, the gland becomes visible as a red or pink mass protruding from the corner of the eye. This exposed gland is no longer protected by the third eyelid and is vulnerable to irritation, dryness, and secondary infection.
Causes of Cherry Eye in Dogs
While the exact cause of cherry eye isn’t fully understood, several factors are believed to contribute to its development:
* **Genetic Predisposition:** Cherry eye is more prevalent in certain breeds, suggesting a genetic component. Breeds commonly affected include:
* Bulldogs (English, French, American)
* Beagles
* Shih Tzus
* Lhasa Apsos
* Cocker Spaniels
* Pekingese
* Boxers
* Bloodhounds
* Newfoundlands
* Saint Bernards
This predisposition indicates that the connective tissue supporting the gland in these breeds may be inherently weaker.
* **Weak Connective Tissue:** As mentioned earlier, the primary cause of cherry eye is the weakness or breakdown of the connective tissue that holds the tear gland in place within the third eyelid. This can be due to genetic factors, congenital defects, or age-related degeneration.
* **Trauma:** Although less common, trauma to the eye area could potentially contribute to the prolapse of the gland. This might involve a direct blow to the eye or persistent rubbing due to irritation.
* **Inflammation:** Chronic inflammation of the eye or surrounding tissues could weaken the connective tissue and increase the risk of cherry eye. This inflammation may stem from allergies, infections, or other underlying conditions.
* **Age:** While cherry eye can occur at any age, it’s most commonly seen in young dogs, typically under two years old. This suggests that the connective tissues may weaken early in life in predisposed breeds.
Recognizing the Symptoms of Cherry Eye
The most obvious symptom of cherry eye is the appearance of a red or pink, round or oval-shaped mass protruding from the inner corner of the dog’s eye. This mass can vary in size but is usually quite noticeable. Other symptoms may include:
* **Visible Red Mass:** This is the hallmark sign of cherry eye. The gland typically appears smooth and moist but can become dry and irritated if exposed for an extended period.
* **Eye Irritation:** Dogs with cherry eye often exhibit signs of eye irritation, such as squinting, excessive blinking, or rubbing the affected eye with their paw or against furniture.
* **Excessive Tearing (Epiphora):** The prolapsed gland may disrupt the normal tear production process, leading to increased tearing or watery discharge from the eye. Paradoxically, in some cases, it can also lead to dry eye because the gland is not functioning properly in its prolapsed state.
* **Dry Eye (Keratoconjunctivitis Sicca – KCS):** In some cases, especially if the cherry eye is chronic or untreated, it can lead to dry eye. This occurs because the prolapsed gland is no longer able to effectively produce tears, leading to corneal inflammation and discomfort.
* **Discharge:** A yellowish or greenish discharge may be present, particularly if the eye has become infected due to irritation and exposure.
* **Swelling:** The tissues surrounding the eye may appear swollen or inflamed.
* **Pain:** While not always apparent, cherry eye can cause discomfort or pain, especially if the gland is irritated or infected.
It’s important to note that cherry eye usually affects only one eye initially, but it can sometimes occur in both eyes simultaneously or sequentially. If you notice any of these symptoms in your dog, it’s crucial to consult with a veterinarian for proper diagnosis and treatment.
Diagnosis of Cherry Eye
The diagnosis of cherry eye is typically straightforward and based on a visual examination of the affected eye. A veterinarian can usually identify the prolapsed gland simply by looking at it. However, to rule out other potential eye conditions and assess the overall health of the eye, the veterinarian may perform the following:
* **Physical Examination:** A thorough physical examination to assess the dog’s overall health.
* **Ophthalmic Examination:** A detailed examination of the eye, including:
* **Visual Inspection:** To confirm the presence of the prolapsed gland and assess its size, shape, and condition.
* **Schirmer Tear Test:** To measure tear production and rule out dry eye. This test involves placing a small strip of filter paper under the lower eyelid to measure the amount of tear production over a specific period.
* **Fluorescein Stain:** To check for corneal ulcers or abrasions. A harmless dye is applied to the eye, and a special light is used to detect any damage to the cornea.
* **Tonometry:** To measure the pressure inside the eye and rule out glaucoma.
* **Medical History:** The veterinarian will inquire about the dog’s medical history, including any previous eye problems, medications, and overall health status. They will also ask about the onset and progression of the cherry eye symptoms.
In some cases, further diagnostic tests, such as blood work, may be recommended to rule out underlying medical conditions that could be contributing to the problem.
Treatment Options for Cherry Eye in Dogs
The primary goal of treatment for cherry eye is to reposition the prolapsed gland back into its normal location within the third eyelid, preserving its tear-producing function. While some outdated approaches involved removing the gland altogether, this is generally discouraged due to the risk of developing dry eye later in life. The current recommended treatment options focus on surgical repositioning.
Here are the most common and effective treatment options for cherry eye:
* **Surgical Repositioning:** This is the preferred method of treatment for cherry eye. Several surgical techniques can be used to reposition the gland, each with its own advantages and disadvantages. The choice of technique depends on the veterinarian’s preference, the severity of the prolapse, and the individual dog’s anatomy. The two most common surgical techniques are:
* **Pocket Technique (Morgan Pocket Technique):** This is one of the most widely used and successful techniques. It involves creating a small “pocket” within the third eyelid and tucking the prolapsed gland back into this pocket. The pocket is then closed with sutures, effectively securing the gland in its normal position. The sutures used are typically absorbable, meaning they will dissolve on their own over time. The benefits of this technique include a relatively high success rate and minimal disruption to the normal anatomy of the eye. The main disadvantage is that the sutures can sometimes irritate the eye or become dislodged, requiring a second surgery.
**Step-by-Step Instructions for the Pocket Technique:**
1. **Anesthesia:** The dog is placed under general anesthesia.
2. **Preparation:** The surgical area around the eye is shaved and thoroughly cleaned with an antiseptic solution.
3. **Incision:** A small incision is made on the inner surface of the third eyelid, creating a pocket.
4. **Gland Repositioning:** The prolapsed gland is carefully repositioned back into the pocket.
5. **Suturing:** The edges of the pocket are closed with absorbable sutures, securing the gland in place. The sutures are carefully placed to avoid irritating the cornea.
6. **Post-Operative Care:** Antibiotic ointment is applied to the eye, and the dog is monitored closely during recovery.
* **Anchoring Technique:** This technique involves suturing the gland to the surrounding tissues, anchoring it in its normal position. This method can be useful for more severe prolapses or when the pocket technique is not feasible. The main advantage of this technique is that it provides strong support for the gland. However, it can be technically more challenging and may have a slightly higher risk of complications, such as suture-related irritation or recurrence of the prolapse.
**Step-by-Step Instructions for the Anchoring Technique:**
1. **Anesthesia:** The dog is placed under general anesthesia.
2. **Preparation:** The surgical area around the eye is shaved and thoroughly cleaned with an antiseptic solution.
3. **Suture Placement:** Sutures are carefully placed through the gland and the surrounding tissues, anchoring the gland in its normal position.
4. **Knot Tying:** The sutures are tied securely, ensuring that the gland is properly positioned.
5. **Post-Operative Care:** Antibiotic ointment is applied to the eye, and the dog is monitored closely during recovery.
* **Surgical Removal (Excision):** While surgical removal of the gland used to be a common treatment for cherry eye, it is now generally discouraged due to the high risk of developing dry eye (Keratoconjunctivitis Sicca – KCS) later in life. The third eyelid gland produces a significant portion of the dog’s tear film, and removing it can lead to chronic dry eye, requiring lifelong medication. Excision should only be considered as a last resort when other surgical techniques have failed or are not feasible.
* **Massage:** In very mild cases, some veterinarians may attempt to manually reposition the gland by gently massaging the eye. However, this method is rarely successful in the long term and is not a substitute for surgery. It may provide temporary relief but does not address the underlying cause of the prolapse.
* **Medications:** Medications are typically used as an adjunct to surgery to manage inflammation, prevent infection, and provide pain relief. They are not a primary treatment for cherry eye but can help to improve the dog’s comfort and promote healing after surgery.
* **Antibiotics:** Antibiotic eye drops or ointments may be prescribed to prevent or treat secondary bacterial infections.
* **Anti-inflammatory Medications:** Non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids may be used to reduce inflammation and pain.
* **Artificial Tears:** Artificial tears can be used to lubricate the eye and prevent dryness, especially if there is a concern about decreased tear production.
Post-Operative Care: Ensuring a Smooth Recovery
Proper post-operative care is crucial for ensuring a successful outcome after cherry eye surgery. Following your veterinarian’s instructions carefully is essential for preventing complications and promoting healing. Here are some important aspects of post-operative care:
* **Elizabethan Collar (E-Collar):** An Elizabethan collar, also known as a cone of shame, is essential to prevent the dog from rubbing or scratching the eye. This is crucial to protect the surgical site and prevent the sutures from being dislodged. The collar should be worn at all times until the veterinarian advises that it can be removed, typically for 10-14 days.
* **Medications:** Administer all prescribed medications as directed by your veterinarian. This may include antibiotic eye drops or ointment, pain relievers, and anti-inflammatory medications. Be sure to follow the dosage instructions carefully and complete the entire course of medication, even if the dog seems to be feeling better.
* **Cleaning:** Gently clean the area around the eye with a warm, damp cloth to remove any discharge or crusting. Avoid putting pressure on the surgical site and be careful not to introduce any irritants into the eye.
* **Rest:** Restrict the dog’s activity level for the first few days after surgery. Avoid strenuous exercise, rough play, and exposure to dusty or dirty environments. A quiet and comfortable environment will help to promote healing.
* **Monitoring:** Monitor the eye closely for any signs of complications, such as:
* **Increased redness or swelling:** This could indicate an infection or inflammation.
* **Discharge:** A yellowish or greenish discharge could also indicate an infection.
* **Pain:** Signs of pain include squinting, rubbing the eye, or reluctance to open the eye.
* **Suture Displacement:** Check for any loose or dislodged sutures.
* **Recurrence of the Prolapse:** Monitor for any signs of the gland protruding from the eye again.
* **Follow-Up Appointments:** Attend all scheduled follow-up appointments with your veterinarian. These appointments are important for monitoring the healing process and addressing any potential complications.
Potential Complications of Cherry Eye Surgery
While surgical repositioning is generally a safe and effective treatment for cherry eye, there are some potential complications that can occur:
* **Recurrence of the Prolapse:** This is the most common complication. The gland may prolapse again, requiring a second surgery. The risk of recurrence can vary depending on the surgical technique used and the individual dog’s anatomy.
* **Infection:** Infection can occur at the surgical site, leading to redness, swelling, discharge, and pain. Antibiotics are typically used to treat infections.
* **Suture-Related Complications:** Sutures can sometimes irritate the eye or become dislodged, requiring removal or further surgery.
* **Dry Eye (Keratoconjunctivitis Sicca – KCS):** Although less likely with gland-sparing surgical techniques, dry eye can still occur if the gland is damaged during surgery or if the blood supply to the gland is compromised. Dry eye requires lifelong treatment with artificial tears and other medications.
* **Corneal Ulcers:** Corneal ulcers can develop if the cornea is damaged during surgery or if the eye becomes dry and irritated. Corneal ulcers require prompt treatment to prevent further complications.
Prevention of Cherry Eye
Unfortunately, there is no guaranteed way to prevent cherry eye, especially in predisposed breeds. However, there are some steps you can take to minimize the risk:
* **Choose a Reputable Breeder:** If you are considering purchasing a dog from a predisposed breed, choose a reputable breeder who screens their breeding dogs for genetic conditions, including cherry eye. While this won’t eliminate the risk entirely, it can reduce the likelihood of your dog developing the condition.
* **Maintain Good Eye Hygiene:** Regularly clean the area around your dog’s eyes with a warm, damp cloth to remove any discharge or debris. This can help to prevent irritation and inflammation that could contribute to cherry eye.
* **Protect the Eyes from Trauma:** Avoid situations that could lead to trauma to the eye, such as rough play or exposure to sharp objects.
* **Address Underlying Conditions:** If your dog has any underlying medical conditions, such as allergies or infections, that could contribute to eye inflammation, be sure to address them promptly.
* **Regular Veterinary Checkups:** Schedule regular veterinary checkups for your dog, including a thorough eye examination. Early detection and treatment of any eye problems can help to prevent complications, including cherry eye.
The Importance of Seeking Veterinary Care
Cherry eye is a condition that requires prompt veterinary attention. While it may not be life-threatening, it can cause significant discomfort and potentially lead to more serious complications if left untreated. It’s crucial to consult with a veterinarian as soon as you notice any signs of cherry eye in your dog. A veterinarian can accurately diagnose the condition, recommend the most appropriate treatment option, and provide guidance on post-operative care. Early intervention can help to minimize the risk of complications and ensure a positive outcome for your furry friend.
Conclusion
Cherry eye is a common but treatable condition in dogs. Understanding the causes, symptoms, and treatment options is essential for responsible pet ownership. By working closely with your veterinarian and following their recommendations, you can help to ensure your dog’s comfort and well-being and preserve their vision. Remember that early detection and prompt treatment are key to a successful outcome. While cherry eye can be a concerning sight, with proper care and attention, your dog can live a happy and healthy life.