Prolapsed Gland (“Cherry Eye”) in Cats: A Vet’s 2025 Guide to Treatment & Prevention 🐱👁️
In this article
Prolapsed Gland (“Cherry Eye”) in Cats: A Vet’s 2025 Guide to Treatment & Prevention 🐱👁️
By Dr Duncan Houston, BVSc
🔍 What Is Cherry Eye?
Cherry eye occurs when the gland of the third eyelid (nictitating membrane) slips out of place and appears as a soft red or pink mass in the inner corner of the eye :contentReference[oaicite:3]{index=3}. This gland produces ~30–50% of a cat’s tear film, so displacement can lead to irritation, dryness, and infection :contentReference[oaicite:4]{index=4}.
⚠️ Causes & Risk Factors
- **Weak anchoring tissue** underlies most cases; this may be congenital or breed-related (e.g. Burmese, Persian) :contentReference[oaicite:5]{index=5}.
- **Inflammation or trauma**—too much scratching, rubbing, or infection can provoke gland prolapse :contentReference[oaicite:6]{index=6}.
- **Common in young cats**, though it can develop at any age :contentReference[oaicite:7]{index=7}.
🚩 Signs & Symptoms
- Visible red/pink mass at the inner corner of the eye :contentReference[oaicite:8]{index=8}.
- Excessive tearing, squinting, pawing or rubbing eye :contentReference[oaicite:9]{index=9}.
- Secondary conjunctivitis or discharge may develop if gland is irritated :contentReference[oaicite:10]{index=10}.
- If left untreated, gland exposure can cause **dry eye (KCS)** — a chronic, vision-threatening condition :contentReference[oaicite:11]{index=11}.
🔬 Diagnosis by Your Vet
- Physical exam: Your vet will confirm the mass is the third eyelid gland and assess tear production with a Schirmer tear test :contentReference[oaicite:12]{index=12}.
- Ophthalmic assessment: Screen for corneal damage, ulceration, glaucoma, or infection :contentReference[oaicite:13]{index=13}.
- Further work-up: In rare cases, tonometry or imaging may be used to rule out other eye diseases :contentReference[oaicite:14]{index=14}.
🛠️ Treatment Options
✅ Surgical Replacement (Preferred)
- **Pocket (envelope) technique** creates a conjunctival pocket to tuck gland back in, preserving tear production and gland health :contentReference[oaicite:15]{index=15}.
- **Anchoring (tacking) techniques** suture the gland against the eye’s lining; often combined with pocket repair for stability :contentReference[oaicite:16]{index=16}.
- **Timing:** Surgery typically occurs once inflammation subsides; in young cats, may coincide with spay/neuter under anesthesia :contentReference[oaicite:17]{index=17}.
- Success rates are ~90%, though one eye may follow another; recurrence in up to 20% of cases may require reoperation :contentReference[oaicite:18]{index=18}.
⚠️ Gland Removal (Not Recommended)
- While technically easier, removal removes tear production capacity and increases risk of KCS :contentReference[oaicite:19]{index=19}.
- Dry eye typically develops months or years later, necessitating lifelong lubrication agents :contentReference[oaicite:20]{index=20}.
💊 Medical Management (Temporary)
- Topical anti-inflammatories (steroid/NSAID drops) and lubrication may reduce swelling temporarily :contentReference[oaicite:21]{index=21}.
- Has limited, often short-lived effect; recurrence common unless surgically corrected :contentReference[oaicite:22]{index=22}.
📅 Post‑Op Care & Recovery
- Elizabethan collar: Prevents discomfort and protects stitches for ~7–14 days :contentReference[oaicite:23]{index=23}.
- Topical Medications: Apply antibiotic/anti-inflammatory drops as directed, typically 2–4 weeks :contentReference[oaicite:24]{index=24}.
- Recheck visits: Monitor tear production and detect early recurrence :contentReference[oaicite:25]{index=25}.
- Manage dry eye: Introduce lifelong lubrication therapy only if post-op tear test is low :contentReference[oaicite:26]{index=26}.
🛡️ Prevention and Long‑Term Monitoring
- **Early detection:** Routine wellness exams help identify cherry eye before complications arise :contentReference[oaicite:27]{index=27}.
- **Breed awareness:** Burmese, Persian, and flat-faced breeds have higher risk—inform breeders and veterinarians :contentReference[oaicite:28]{index=28}.
- **Protect gland stability:** Address underlying chronic eye inflammation (allergies, infection) promptly :contentReference[oaicite:29]{index=29}.
- **Avoid gland removal:** Always opt for gland-preserving surgery to retain tear production :contentReference[oaicite:30]{index=30}.
📊 Quick Reference Table
| Aspect | Details |
|---|---|
| Name | Prolapsed third eyelid gland (“cherry eye”) |
| Signs | Red mass, tearing, pawing, discharge |
| Diagnosis | Physical exam + tear test + ocular assessment |
| Treatment | Surgical replacement (pocket/tack); gland removal discouraged; meds short-term |
| Risks | Recurrence (up to 20%), dry eye if gland removed |
| Prognosis | Excellent with surgery; dry eye manageable |
| Prevention | Early detection, preserve gland, manage eye health in predisposed cats |