Cherry Eye in Dogs: Causes, Treatment and Surgery

What Does Cherry Eye Look Like?

• A smooth, red or pink, oval swelling in the inner corner of the eye, near the lower lid^2,1
• It may appear suddenly, shrink back for a while, and then reappear^1,3
• It can affect one or both eyes, not always at the same time^5,6
• The exposed gland can become irritated and swollen, and the eye may water or have discharge. Dogs may rub or paw at it.^1,7

Other lumps in the corner of the eye can look similar, so have your vet confirm what it is.

Which Dogs Get Cherry Eye?

In a UK study of more than 900,000 dogs, about 1 in 500 dogs had cherry eye recorded in a single year, and the median age at diagnosis was about 7 months.⁴ Most cases appear in the first year or two of life.^4,7,5

Flat-faced (brachycephalic) breeds had nearly 7 times the odds of breeds with medium-length noses.⁴ Breeds at highest risk include:^4,2,5

• Neapolitan Mastiffs, English Bulldogs and Cane Corsos, which had the highest odds in the UK study
• Lhasa Apsos, American Cocker Spaniels, Beagles, Shih Tzus, Pekingese, Boston Terriers and French Bulldogs
• Other mastiffs, Great Danes, Bloodhounds, Newfoundlands and Pugs

Any breed can be affected.^5,6

What Causes Cherry Eye?

The fibrous tissue that anchors the gland is weak, likely an inherited trait, so the gland slips out of place. Once that tissue has broken down, it can't repair itself.^5,2,4 Inflammation that enlarges the gland and the shape of the head and eyelids in flat-faced breeds may add to the problem.^6,7 There's no known way to prevent it.⁷

Is Cherry Eye Painful or an Emergency?

Cherry eye isn't usually an emergency, but your dog should see a vet soon.^7,1 The longer the gland stays out, the more irritated and swollen it becomes, which can make surgery harder and lower the chance of a good result. Rubbing can also injure it.^1,7

See a vet promptly if your dog is squinting, the eye looks cloudy, or there's thick discharge, because these can mean another eye problem such as an ulcer.^8,9

Until the vet visit: your vet may suggest a lubricating eye gel or ointment to keep the gland from drying out, and a cone to stop rubbing.^7,2

Can Cherry Eye Go Away on Its Own or Be Treated Without Surgery?

Sometimes the gland slips back by itself for a while, but it rarely stays in place without surgery.^3,1,7 A vet may be able to push a recently prolapsed gland back into place and prescribe anti-inflammatory eye medicine, but most glands put back this way prolapse again.^6,7 Eye drops can soothe the irritation but won't fix the weak attachment.^2,6

Don't try to push the gland back yourself. When it's done, it's done by a vet, using numbing drops.^6,7

Cherry Eye Surgery

Surgery to put the gland back in place is the recommended treatment.^2,1,3 There are two main approaches:^5,6,3

• Pocket (Morgan pocket or imbrication) technique: the surgeon makes a pocket in the lining of the third eyelid and tucks the gland into it. The American College of Veterinary Ophthalmologists calls it the typical procedure of choice.^5,6
• Anchoring (tacking) techniques: the gland is stitched to deeper tissue near the eye. Surgeons sometimes combine anchoring with a pocket, especially in large breeds such as Bulldogs and Boxers.^6,10,5

An evidence review found no proof that one technique is clearly better than the other, so your vet will choose based on your dog.^11,6

Success rates: most surgeries work. The American College of Veterinary Ophthalmologists reports about 92% success, and a study of 420 eyes in 353 dogs found that 95% of glands stayed in place.^5,10 Overall, about 5% to 20% of glands prolapse again and need another operation; the risk is higher in Bulldogs and other large, flat-faced breeds.^2,7,6

Cost: prices vary widely by region and by whether a general vet or a board-certified veterinary ophthalmologist does the surgery, and by whether one or both eyes need repair. Ask for an estimate. Fixing it early, while the gland is healthy, gives the best chance of a single successful surgery.^1,7

Why the Gland Shouldn't Be Removed

The third eyelid gland makes roughly a third to over half of the watery part of the tears.^1,5,4 Removing it greatly raises the risk of dry eye (keratoconjunctivitis sicca, or KCS): about 30% to 40% of dogs go on to develop dry eye later in life after the gland is removed. Dry eye can be painful, can damage the cornea, and usually needs medication every day for life.^3,1 Removal is reserved for rare cases such as a tumor or a gland that is too damaged to save.^2,6

Even after successful replacement, some dogs develop dry eye later, so ask your vet to check tear production regularly.^3,5,6

Recovery and Aftercare

• Many dogs wear a cone after surgery to stop them rubbing the eye; flat-faced breeds almost always need one.⁶
• In most dogs the gland looks normal within a few weeks of surgery.²
• Watch for the gland reappearing, and tell your vet if it does.^2,7
• Many dogs with cherry eye in one eye eventually get it in the other.² Surgery on an eye that hasn't prolapsed isn't recommended, because it can sometimes trigger a prolapse.⁷
• Have tear production checked regularly for life. The American College of Veterinary Ophthalmologists advises checking both eyes at least twice a year.^5,6

For other eye problems, see dog eye infections and conjunctivitis in dogs.

Frequently Asked Questions

Can cherry eye in dogs heal on its own?

The gland sometimes slips back for a while, but it rarely stays in place. Most dogs need surgery to fix it permanently.

Can I push my dog's cherry eye back in?

Don't try it without your vet's guidance. A vet can sometimes push a newly prolapsed gland back in, but it usually pops out again, and surgery is the lasting fix.

What happens if cherry eye isn't treated?

The exposed gland stays irritated and swollen, can be injured by rubbing, and may stop producing tears normally. Long-standing cases are harder to repair, and dry eye becomes more likely.

Is cherry eye painful for dogs?

The exposed gland can become irritated and uncomfortable, and dogs may rub at it. Squinting or a cloudy eye may mean another problem, so see your vet.

Can eye drops fix cherry eye?

No. Lubricating or anti-inflammatory drops can soothe the gland while you wait for treatment, but they don't fix the weak attachment that lets it slip out.

How successful is cherry eye surgery?

Most repairs work: success rates of about 90% to 95% are reported. Some glands slip out again and need a second surgery, more often in Bulldogs and other large, flat-faced breeds.

Should the gland be removed?

No, except in rare cases such as a tumor. The gland makes a large share of the eye's tears, and removing it greatly raises the risk of lifelong dry eye.