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If a Red Mass Protrudes from Your Dog’s Eye — Causes of Cherry Eye and When to Visit the Vet

Eye HealthQ&AMeongsiljang Veterinary Advisory Board

Cherry eye in dogs, or third eyelid prolapse, is a condition where a red, fleshy mass protrudes from the lower part of the eye. While it’s easy for pet owners to spot, the timing and method of treatment are crucial. Here are answers to some of the most common questions.

Cherry Eye in Dogs Is a Condition Where Red Flesh Protrudes from the Lower Part of the Eye

A puppy with a red, protruding third eyelid

Cherry eye in dogs occurs when the tear gland, located on the inner side of the third eyelid (nictitating membrane), slips out of place and protrudes into the inner corner of the eye, appearing as a red, fleshy mass. While it may affect only one eye, it commonly occurs in both eyes simultaneously or may start in one eye and progress to the other. - Main Causes of Cherry Eye: This condition arises when the connective tissue that holds the tear gland in place is congenitally weak, causing the gland to become loose. Genetic predisposition plays a significant role in certain breeds. - When to Check for Symptoms: Early veterinary evaluation is necessary if you notice a red mass in the inner corner of the eye or if your dog frequently rubs its eyes. This condition is most commonly seen in young puppies. - Importance of Treatment: If left untreated, the exposed tear gland can dry out, leading to dry eye (keratoconjunctivitis sicca). This increases the risk of conjunctivitis, secondary bacterial infections, and ulcerative keratitis. - Diagnosis Method: A veterinarian will diagnose the condition by directly examining the eye and third eyelid under light. If abnormalities are detected, prompt veterinary care is essential.

The Main Causes of Cherry Eye Are Genetic Predisposition and Weakness of the Eyelid Muscle

The most common cause of cherry eye is a congenital weakness in the connective tissue that holds the tear gland of the third eyelid in place. Because genetic predisposition plays a significant role in certain breeds, some puppies are at risk from a young age. - Genetic factors: The condition is more prevalent in small to medium-sized breeds such as the Basset Hound, Beagle, Boston Terrier, Cocker Spaniel, English Bulldog, Lhasa Apso, Pekingese, and Shih Tzu. - Onset: Rather than being caused by muscle aging, cherry eye typically appears in young puppies with inherently weak connective tissue. - Prevention: Early detection and proper management can help reduce complications. - Treatment strategy: Understanding the underlying cause aids in developing an effective treatment plan, making early intervention essential.

An anatomical illustration showing the third eyelid and muscle structure of a dog's eye

4 Signs Owners Should Check for When Cherry Eye Is Suspected

If you suspect your pet has cherry eye, there are specific signs you should check for: - Look for a red mass: Carefully examine the lower part of the eye to see if a red, fleshy tissue is protruding. - Watch for eye-rubbing behavior: Pay close attention to whether your pet frequently rubs or scratches at their eyes. - Check for increased tearing: Observe if there is excessive tearing or visible tear stains around the eyes. - Monitor for redness and swelling: Check if the eye appears red, swollen, or feels warm to the touch. If you notice any of these symptoms, consult your veterinarian immediately.

Your dog scratching at its eyes, with redness around the eye area

Signs Requiring Immediate Veterinary Care

If your pet’s eyes become severely red, tear excessively, or if they have trouble opening or closing their eyes, seek veterinary care immediately. These symptoms may indicate an infection or corneal damage, which require prompt treatment.

Cherry Eye Is Diagnosed Through a Veterinary Eye Examination and Ophthalmic Instruments

Diagnosing cherry eye begins with a clinical examination in which the veterinarian directly inspects the eyes and the third eyelid. - Visual and magnified examination: The veterinarian carefully examines the eyelids, conjunctiva, third eyelid, and cornea under illumination. - Tear test (Schirmer tear test): This measures tear production to assess whether tear gland function is reduced (normal is approximately 17 mm/min). - Fluorescein staining: This helps detect ulcers or damage on the cornea. - Need for specialized care: An ophthalmology consultation can be helpful when a more precise evaluation is required. - Accurate diagnosis: Early diagnosis supports effective treatment and recovery.

A veterinarian examining a dog's eye with a slit lamp

Cherry Eye Treatment Options: Choosing Between Conservative Management and Surgery

Treatment for cherry eye varies depending on the severity of symptoms. - Conservative treatment: In mild cases, eye drops can be used to reduce inflammation. However, this is only a temporary solution and does not address the underlying issue. - Surgical treatment: In most cases, surgery is required to reposition the third eyelid back into its normal place. - Surgical safety: With current techniques, the procedure is safe and has a low recurrence rate. - Recovery period: After surgery, activity should be limited and careful management is needed for 1–2 weeks. - Treatment decision: The best approach should be chosen in consultation with your veterinarian, based on your pet’s individual condition.

An anatomical illustration showing the appearance of a dog during third eyelid surgery

4 Post-Operative Care Points

Post-operative care is crucial for preventing recurrence and ensuring a smooth recovery. - Prevent eye rubbing: Use an Elizabethan collar (cone) to stop your dog from touching or scratching the surgical site. - Eye drop administration: Apply eye drops regularly as directed by your veterinarian to prevent infection at the surgical site. - Activity restriction: Limit walks and avoid vigorous play for a specified period after surgery. - Regular check-ups: Visit the clinic according to the schedule provided by your veterinarian to monitor your pet’s recovery progress. - Monitor recovery: Seek immediate veterinary attention if you notice any abnormal symptoms such as redness, pain, or recurrence.

A puppy wearing a protective cone after eye surgery.

Caution Is Needed Due to the Possibility of Recurrence

The third eyelid can prolapse again even after surgery, especially in breeds with a strong genetic predisposition, where the risk of recurrence is higher. Continue to monitor your pet’s eye condition closely after the procedure, and return to the clinic if any abnormalities are noticed.

Reviewed by a veterinarian

Dr. Tony — Punnawat Phongkittirak

Veterinarian

A veterinarian who majored in veterinary medicine at Khon Kaen University, Thailand, and completed the IVSA program at North Carolina State University in the United States. Drawing on clinical experience at animal hospitals, he works in the pet healthcare field and is dedicated to building a digital care environment that connects pet parents with veterinarians.

Frequently Asked Questions

What causes cherry eye?

The connective tissue that holds the tear gland of the third eyelid in place may be congenitally underdeveloped, making this condition more common in breeds with a strong genetic predisposition. It tends to appear more frequently in young puppies than in older dogs.

Can cherry eye be treated at home?

No. Because the condition of the eye can worsen or become infected, it is strictly forbidden for pet owners to manually push it back into place. You must have your pet examined by a veterinarian.

How painful is cataract surgery?

Your dog won’t feel any pain during the surgery because they’ll be under anesthesia. While there may be some discomfort afterward, your veterinarian will prescribe appropriate pain medication to keep them comfortable. Recovery times vary from dog to dog, so please follow your vet’s guidance for proper post-operative care.

Can cherry eye recur after surgery?

Although recurrence is possible, surgical techniques such as the conjunctival pocket method significantly reduce the likelihood of it happening again. In breeds with a strong genetic predisposition, the condition may also develop in the opposite eye, so it’s important to continue monitoring your pet’s eye health closely even after surgery.

Does every dog with a cherry eye need surgery?

While mild or early cases can be managed conservatively, cherry eye (prolapse of the third eyelid gland) often becomes permanently fixed over time, making surgery necessary in many cases. It is best to consult with your veterinarian to determine the most appropriate treatment plan for your pet’s specific situation.

Comparison of Cherry Eye Treatments: Conservative Management vs. Surgery

Item	Conservative Management	Surgical Treatment
When applied	Mild symptoms, first occurrence	Recurrent, causing pain, affecting vision
Duration of effect	Temporary, high chance of recurrence	Long-term, low recurrence rate
Cost	Low (eye drops, etc.)	High (including surgery fees)
Possibility of side effects	Eye drop irritation, excessive tearing	Post-surgical infection, recurrence

Surgery has a low recurrence rate and long-term effect, but requires cost and a recovery period. Conservative management has a temporary effect but is low-cost and low-burden.

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References

[1] Coté E. Clinical veterinary advisor. Dogs and cats. 3rd ed. St. Louis, MO: Elsevier Mosby; 2015.

[2] Ettinger SJ, Feldman EC, Côté E. Textbook of veterinary internal medicine: diseases of the dog and the cat. 8th ed. St. Louis, MO: Elsevier; 2017.

[3] Maggs DJ. Third eyelid. In: Maggs DJ, Miller PE, Ofri R, Slat... Clinical Atlas of Canine and Feline Ophthalmic Disease, 2nd Ed.