CONDITION

Cherry Eye

Why this matters now

Cherry eye most commonly occurs in puppies and young dogs under two years of age, though it can develop at any age. Certain breeds are strongly predisposed, including Bulldogs, Cocker Spaniels, Beagles, Shih Tzus, and other brachycephalic or hound breeds. When it occurs in one eye, there is an increased likelihood of the other eye being affected subsequently.

The condition typically appears suddenly as a pink or red mass emerging from the inner corner of the eye. Initially, the prolapsed gland may appear intermittently before becoming permanent. Without repositioning, the exposed gland tissue becomes irritated and swollen, potentially leading to secondary conjunctivitis and reduced tear production. The gland cannot return to its normal position spontaneously once fully prolapsed.

Signals & patterns

Early signals

Intermittent pink mass at inner eye corner

The prolapsed gland may initially pop in and out, particularly visible when the dog wakes or is relaxed.

Increased eye watering

Early prolapse may cause reflex tearing as the eye responds to the abnormal tissue position.

Mild rubbing at the affected eye

Some discomfort or awareness of the abnormal tissue may prompt occasional pawing.

Slight redness at the inner eye corner

Before full prolapse, mild inflammation may be visible where the gland is beginning to protrude.

Later signals

Permanently visible red or pink mass

The prolapsed gland remains visible as a smooth, rounded mass at the inner corner of the eye.

Swollen, inflamed appearance of the mass

The exposed gland tissue becomes progressively swollen and congested due to poor drainage.

Mucoid discharge from the affected eye

Secondary conjunctivitis and disrupted tear production may cause thickened discharge.

Dry eye signs developing

If the prolapsed gland function is compromised, symptoms of reduced tear production may emerge over time.

Click to read about the biological mechanisms

How this is usually investigated

Diagnosis is typically straightforward based on the characteristic appearance. Further assessment determines whether the condition has affected tear production or caused secondary problems.

Visual examination

Purpose: To confirm the diagnosis and assess the size and condition of the prolapsed gland
Considerations: The smooth, pink, rounded mass at the inner eye corner is diagnostic. The degree of swelling and inflammation guides urgency.

Schirmer tear test

Purpose: To measure tear production from both glands
Considerations: Baseline measurement before treatment helps monitor for dry eye development. May be repeated after surgical repair.

Fluorescein staining

Purpose: To check for any corneal damage from exposure or rubbing
Considerations: Ensures no concurrent corneal ulceration requiring treatment.

Assessment of the other eye

Purpose: To evaluate the position of the gland in the unaffected eye
Considerations: Bilateral involvement is common. Early changes in the second eye may indicate need for monitoring or preventive discussion.

Options & trade-offs

Surgical repositioning is the standard approach to preserve gland function. Various techniques exist, and removal of the gland is generally avoided.

Pocket technique (mucosal pocket)

The gland is repositioned into a surgically created pocket in the conjunctiva.

Trade-offs: Widely used with good success rates. Preserves gland function. Recurrence can occur, requiring revision surgery.

Anchoring technique

The gland is sutured to deeper orbital structures to prevent re-prolapse.

Trade-offs: Various anchoring points described. May be combined with pocket techniques. Risk of suture-related complications.

Morgan pocket modification

A single-incision pocket technique that may reduce surgical time.

Trade-offs: Simpler approach that can be effective. Success depends on gland size and surgeon experience.

Gland removal (generally not recommended)

Complete excision of the prolapsed gland.

Trade-offs: Previously common but now avoided when possible due to high risk of subsequent dry eye. Reserved for severely diseased glands or failed multiple repairs.

Medical management whilst awaiting surgery

Lubricating drops to protect the exposed gland and cornea.

Trade-offs: Does not resolve the prolapse but may reduce inflammation. Cannot substitute for surgical correction.

Common misconceptions

Misconception:

"The prolapsed gland can be pushed back permanently"

Reality:

Whilst the gland may temporarily return to position with gentle manipulation, it will re-prolapse without surgical repair of the weakened attachments.

Misconception:

"Cherry eye is just a cosmetic problem"

Reality:

The nictitans gland produces a substantial portion of tear fluid. Untreated prolapse or gland removal risks significant dry eye development.

Misconception:

"Removing the gland is a simple solution"

Reality:

Gland removal leads to reduced tear production in many cases, requiring lifelong management for dry eye. Repositioning surgery is strongly preferred.

When a pink mass appears at a dog's inner eye corner, prompt assessment can help determine appropriate management. Noting whether the mass appeared suddenly or gradually, and whether it was initially intermittent, provides useful history. Owners of predisposed breeds might benefit from awareness that this condition commonly affects both eyes, sometimes months or years apart.

Last reviewed: 24 April 2026 · Dr Alastair Greenway MRCVS