Cherry Eye in Dogs: Treatment Options and UK Costs
Cherry eye is one of the most recognisable eye conditions in dogs — a bright red, fleshy lump appearing in the inner corner of the eye, looking a little like a cherry. It is caused by prolapse of the gland of the third eyelid and while it looks alarming, it is not a medical emergency. However, it does require veterinary treatment to protect long-term eye health.
Key takeaways
- Cherry eye should be treated surgically by replacing the gland — removing it permanently increases the risk of dry eye and is now considered outdated practice.
- Surgery costs £400–£800 per eye at a general practice; many affected breeds need both eyes treated.
- Prompt treatment prevents the exposed gland from drying out and reduces the risk of long-term dry eye complications.
What Causes Cherry Eye?
Dogs (and cats) have three eyelids: upper, lower and the nictitating membrane or 'third eyelid', which sweeps horizontally across the inner corner of the eye. Embedded within this third eyelid is a tear gland — the nictitans gland — that produces a significant portion of the tear film (approximately 30–40 per cent in dogs). In cherry eye, the connective tissue anchoring this gland to the underlying orbital rim weakens and the gland flips out, becoming visible as a red-pink ovoid mass.
The exact cause of the weakness is not fully understood but is believed to be developmental, with a hereditary component in predisposed breeds. It is particularly common in Cocker Spaniels, Beagles, Bulldogs, French Bulldogs, Boston Terriers, Shih Tzus, Lhasa Apsos and Cavalier King Charles Spaniels. It typically affects young dogs under two years of age and often occurs bilaterally — the second eye may prolapse weeks or months after the first.
Signs and Complications
The most obvious sign is the red fleshy mass in the inner corner of one (or both) eyes. The dog may paw at the affected eye, and increased blinking or squinting (blepharospasm) may occur if the exposed gland becomes irritated or inflamed. The exposed gland dries out quickly if left untreated, leading to chronic inflammation, reduced tear production and keratoconjunctivitis sicca (KCS, or 'dry eye').
KCS is a painful, lifelong condition requiring daily medication, which is why prompt treatment of cherry eye is important — not just cosmetically but to preserve the gland's function and prevent dry eye. In some cases, even after successful surgical correction, reduced tear production can persist if the gland has been inflamed for a prolonged period before treatment.
Treatment Options and Costs
The preferred treatment for cherry eye is surgical replacement of the gland — not removal. Historically, the gland was simply excised, but this is now strongly discouraged because it permanently removes a significant portion of tear production and greatly increases the lifelong risk of dry eye. Modern techniques 'pocket' or 'tack' the gland back into its correct anatomical position.
The most common procedures are the pocket technique (creating a conjunctival pocket to contain the gland) or the Morgan's pocket technique. Under general anaesthetic, the procedure typically costs £400–£800 per eye at a general practice, or £600–£1,200 at a specialist ophthalmology centre. Both eyes may need treatment. The success rate for first-time surgical repair is around 80–90 per cent; a small proportion of dogs require a second surgery. Topical lubricants and anti-inflammatory eye drops are used in the weeks after surgery.
Can Cherry Eye Come Back?
Yes, recurrence is possible even after successful surgery, particularly in highly predisposed breeds. The recurrence rate varies by technique and surgeon experience but is generally quoted at 10–20 per cent. Some dogs with multiple recurrences require a combination technique or referral to a veterinary ophthalmologist.
If the gland cannot be successfully replaced, a partial conjunctival flap procedure may be considered as a last resort to protect remaining tear function. Ongoing monitoring of Schirmer tear test results (a test for tear production) is recommended, particularly in predisposed breeds, to detect dry eye early if it develops post-operatively. Schirmer testing is simple, quick and costs around £15–£30 as part of a check-up.
Find a Vet Near You
Cherry eye treatment costs vary between practices and between general and specialist ophthalmology centres. Use CompareMyVet at app.comparemyvet.uk to find and compare local vet prices, so you can make the best decision for your dog's eye health.
Common questions
The prolapsed gland itself is not initially painful, but the exposed tissue quickly becomes inflamed and irritated, which causes discomfort. Dogs often paw at the affected eye. Left untreated, the development of dry eye is a painful chronic condition, so early treatment protects long-term comfort.
Gentle manual reduction can sometimes temporarily reposition the gland, and some vets may attempt this with lubrication. However, the gland virtually always prolapses again without surgical correction. Surgery is the only reliable long-term treatment.
Most pet insurance policies cover cherry eye surgery as it is classified as an illness rather than a pre-existing congenital condition, provided the policy was taken out before symptoms appeared. Always check your policy wording and any breed-specific exclusion clauses.
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