The third eyelid or nictitans membrane is a small piece of tissue under the inner corner of the eye between the globe and the lower eyelid. This membrane moves across the eye sweeping away debris and helping to spread tears across the cornea. On the inside aspect of this membrane is a gland known as the nictitans or third eyelid gland. The lacrimal gland situated above the eye produces the remainder of the tears. This gland produces part of the tears and in some cases can produce 20% to 55% of the total amount of tears. The nictitans gland normally is not seen and held in it’s natural position by ligaments.
Bulldog. Boston Terrier, Cocker Spaniel, Lhasa Apso, Mastiff and Shi-Tsu are among some of the breeds predisposed to a laxity of the ligaments that hold this gland in it’s natural position.
When the gland “ pops out “ of its normal anatomic position it prolapses and has a cherry-like appearance, giving it the distinctive name. If exposed too long the gland may become damaged, ulcerate and bleed or stop producing tears. In long-standing cases some glands have transformed into tumors.
Surgical repair is warranted. The gland can be repositioned with suture material to the ventral orbital rim called nictitans gland orbitopexy or placed in a pouch of conjunctival tissue known as the pocket technique. These techniques are associated with a 90% success rate. In 10% of the cases it is necessary to repeat the procedure. The newest technique is the Inferior Rectus Muscle Technique which is a more secure repair, takes less time to heal and is associated with a greater success rate. It is worthwhile to remember that the other eye is predisposed to cherry eye though not all dogs develop this condition in both eyes. Bulldog and Mastiff are associated with a high failure rate.
The longer the gland is prolapsed the more difficult is the repair and the greater the chance of surgical failure. Often the nictitans membrane can be malformed and may require surgical correction as well.
Surgery is performed on an outpatient basis.
CBC, blood chemistries and T4 are needed pre-operatively. If done by your regular veterinarian please have the results faxed to our office. If older than 10 years of age have your regular veterinarian take chest-x-rays before any surgery and call us with the results.
Surgery will not be performed on the same day as the initial visit.
Food and water are withheld after midnight the night before surgery.
Drop off time is 8:00 AM the day of the procedure.
Patients are sent home the same day with aftercare instructions and medication.
Some dogs such as Great Dane and Weimaraner also can have concurrent scrolling of the nictitans membrane. If this occurs we will correct this at the time of surgery.