BARNFARMBORDEAUX

Cherry Eye                                                                                              Cherry eye is the common name for a the condition caused when the gland of the third eyelid of the dog, otherwise known as Harder's gland or nictitans gland, becomes inflamed, swells up, pops out of place on the bulbar side of the third eyelid, and becomes more inflamed, swollen and irritated such that it becomes bloody and ulcerated, and can cover 1/2 to the whole eyeball of the dog.  The condition is then referred to as follicular conjunctivitis.  It used to be that when dogs developed cherry eye, veterinarians would simply remove the gland, just as medical doctors routinely removed inflamed tonsils in people. Within the past decade or so, it has now been decided that removing the gland is bad because perhaps the removal of that gland will result in reduced tear production leading to dry eye or keratoconjunctivits sicca.  So now veterinarians routinely want to sew the prolapsed gland back in its original place on the third eyelid, sort of under the eyeball.  There are other glands around the eyeball which make tears, and the gland of the third eyelid is not the major gland, but veterinarians are afraid of doing anything which might reduce tear production and cause the dry eye.   Therefore, veterinarians all over the country refuse to remove the prolapsed gland from a Neo's eye with the resulting catastrophes as depicted by the photos below.

This is a cherry eye in a 3 months old puppy.

This is the eye about 1 minute later.  It took a minute to remove the gland.

This is a cherry eye which had been sutured down once by an opthalmologist and which popped out again. It had to be removed, and of course the removal is much more difficult when there is lots of scar tissue from the attempts to suture it down.

This is a cherry eye which had been sutured down twice at a veterinary school and popped out again. It was finally removed, and the owners have had no complaints of dry eye for the  years since its removal.

This puppy had 2 cherry eyes which had been sutured down, twice on one side and once on the other by two different veterinarians before the owner finally was able to find a veterinarian to remove them.

This puppy has a cherry eye which had been sewn down.  It also has a dry eye in spite of the cherry eye still being there.  The cornea is cloudy because of the keratoconjunctivitis sicca.

It is difficult to see in the photo, but the lashes from the upper lid are dragging onto the eyeball irritating it, causing a conjunctivitis or inflammation of all the tissue around the eyeball, and leading to the development of the cherry eye, which as we said before is follicular conjunctivitis around the gland of the third eyelid.  Since it is a requirement of the standard that Neapolitan Mastiffs have heavy wrinkling of the face, then it is common that the heavy wrinkling of the brow forces inward turning of the upper eyelid.  The lashes drag onto the eyeball causing the chronic irritation.  This irritation leads to the development of the cherry eye.   It is also this severe chronic irritation which causes perhaps an immune mediated response which leads to lack of tear production and dry eye and corneal problems. 

What veterinarians who refuse to remove the irritated cherry eye do not understand is that:
1.  Some Neos can have the cherry eye removed and never get dry eye.
2.  Some Neos never have the cherry eye develop and still get dry eye.
3.  Some Neos have the cherry eye removed and do get dry eye, but usually these dogs have the lashes dragging onto the cornea because the owners do not want to pay to get an entropion procedure done.

4.  One can't successfully sew down the huge, irritated cherry eye of the Neapolitan Mastiff because the Neapolitan Mastiff's connective tissue is so lax and stretchy that no matter what kind of sutures are put in, the gland slips right out again. The tissue just stretches out again.  The cartilage in the third eyelid is also very soft, not rigid, and it slips out right along with the cherry eye, so there is nothing solid or stable to hold the inflamed gland in place.  Perhaps the suturing procedure will work in the non typey, tight skinned Neos which do not adhere to the Neapolitan Mastiff standard.  In a normal typey, loose tissued Neo, however, the suturing down procedure does not work.  It usually causes more problems than it solves.

July 28, 2003. 
It appears that since the time I published the above photos and information, veterinarians all over the country are still refusing to remove cherry eyes in Neos.  Now there is a new technique---the pocket technique, where they try to make a pocket between the bulbar conjunctiva and the third eyelid and tuck the cherry eye into the pocket.  Well, this is a bigger disaster than the other tie down techniques, as shown by the photos of a 1 1/2 yr old Neo which had had both cherry eyes tucked into the pocket.  This procedure had been done by an Ohio State graduate, and when the owners of the dog contacted Ohio State in effort to do another procedure to remedy the one which had been done, they were told that Ohio State would just repeat the procedure, but could not do it until October, 2003.  The dog would have had to go around for 2 more months in the state in which he was presented to me, plus, he would just have been butchered even more.  It is interesting how certain people refuse to listen and learn new things.

1.  

Here is the dog, anesthetized with his eyes closed.  You notice, he can't close them because of the "tucked in" cherry eyes.

2.  

Here is the third eyelid being pulled forward to show you the dehisced edge of the bulbar conjunctival flap with the granulomatous mess on the inside of the third eyelid.

3. 

Here is the anesthetized dog after we were able to remove most of the granulomatous glands.

Of course, every veterinarian's question is, " Well, the dog will get a dry eye with the glands removed." My reply is, "So you want him to go around with the abomination you created by trying to leave these infected masses in the eyes?"  Also, the Neo will get a dry eye sometimes, with or without surgery for cherry eye, and, the Neo might not get dry eye with or without removal of the cherry eye.