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Frequently, pets are presented to us for evaluation of a large bump
“on the eye” near
the nose which is known as “Cherry Eye”. This problem is seen most
often in the smaller breeds -- especially Boston terriers, Cocker
spaniels, bulldogs and beagles but can occur in any breed and can
even occur in cats.
The cherry eye is actually an inflamed tear gland associated with
the third eyelid (nictitans membrane). The normal canine eye
receives its tear film from two lacrimal (tear-producing) glands.
One gland is located above the eye and the other is found within the
animal's third eyelid. The gland of the third eyelid contributes a
significant portion of secretion to the tear film (about 70%). The
gland may swell up due to clogging of the duct, or irritation with
particulate irritants or bacterial or viral infection. As it swells,
it can “float” up from its normal position in back of the third
eyelid, to the top of the gland. When the gland prolapses out of its
normal position the venous drainage of the gland is impeded and so
it remains bulbous. In addition, the gland cannot deliver its tears
to the eye when it is in this position and the eye may begin to
suffer from the lack of nutrients and lubrication found in the
tears.
How do we treat Cherry Eye?
In older times, the prolapsed gland was treated like a small tumor;
it was simply removed. This was before the full significance of the
gland was realized. Most of the pets that had their glands removed
in this fashion went on to develop dry eye syndrome. In this
syndrome, the cornea of the eye begins to turn black with pigment as
a result of lack of tears. These eyes are much more prone to
infections and ulceration. Moreover, they are very uncomfortable to
the pet.
Today, we treat "Cherry eye” by replacing the gland to its
appropriate position and anchoring it there surgically. Simple
manual replacement of the gland will not fix it as the gland will
simple float back up in a few hours to a few days.
The surgical procedure is done under general anesthesia. A small
incision is made near the bottom lid of eye and a special suture
technique is employed to anchor the gland down to the bony orbit
around the eye. After the surgery, topical antibiotic and
anti-inflammatory drops are applied 3-4 times daily. The pet must
keep an Elizabethan collar on to prevent trauma to the surgical
site. The gland may remain swollen for a few days, but since it is
in the correct position, it can perform its function properly.
Occasionally (10%), this procedure may fail (usually due to suture
rupture or tear out) and may have to be repeated.
In some pets, the gland may have been out of position for so long,
that the eye is suffering from dry eye syndrome. In this case,
additional therapy may be instituted to help repair the cornea.
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