The medical term for 'cherry eye' is nictitans gland prolapse, or
prolapse of the gland of the third eyelid. Unlike people, dogs have a
'third eyelid' that contains a tear gland and is located in the corner
of each eye. Under normal circumstances, this gland is not visible and
aids in the production of tears. For some reason, which is not
completely understood, the gland of the third eyelid prolapses or comes
out of its normal position and swells creating the condition known as
cherry eye.
What dogs are likely to get cherry eye?
Any dog can develop cherry eye, but there are several breeds that
appear to have a higher incidence of developing it in both eyes. They
are: the Beagle, Bloodhound, Boston Terrier, Bulldog, Bull Terrier,
Lhasa Apso, Saint Bernard, and Shar-Pei. Dogs can acquire this
condition at any age and it affects males and females equally.
What causes it?
The exact cause of cherry eye is not known, but it is strongly suspected that it is due to a weakness of the connective tissue
that attaches the gland to the surrounding structures of the eye. The
weakness of the connective tissue allows the gland to prolapse. Once
the gland prolapses and is exposed to the dry air and irritants, it can
become infected and/or begin to swell. The gland often becomes
irritated, red, and swollen. There is sometimes a mucous discharge and
if the animals rub or scratch at it, they can traumatize the gland
further or possibly create anulcer on the surface of the eye.
What is the treatment?
Treatment of cherry eye is very straightforward and consists of surgically repositioning the gland. Topical
or injectable treatments of antibiotics and steroids are rarely
effective in reducing the gland and allowing for correction without
surgery. Because the exposed gland is at greater risk for further
trauma or infection, prompt surgical replacement is the best choice.
At one time, it was popular to surgically remove the gland as a way
to correct this condition. While this procedure is often effective, it
can create many problems later in the animals life. The gland of the
third eyelid is very important for the production of tears. Without the
tears produced by the third eyelid many dogs could suffer from the
condition known as 'dry eye.' Dry eye or keratoconjunctivitis sicca
(KCS) is a serious condition that results from the decreased production
of tears. When the third eyelid gland is removed, we are greatly
increasing the chances for the development of this condition. The much
better and preferred surgical option is to surgically tack the gland
back into place with a suture that attaches the gland to the deeper
structures of the eye socket. Most of these surgeries are performed
quickly and have very few complications, and allow the gland to return
to normal function. After the surgery, some animals may need to be
placed on antibiotic ointment for a few days.
Entropion is a condition in which the lower eyelid margins roll inward to the
extent that hair rubs on the surface of the eyeball. In some cases, the
upper lid can also be affected to some degree. One or both eyes may be
involved. This condition can occur in all breeds, however, Spaniels,
Great Danes, Shar-Peis, Poodles, and Saint Bernards seem to be the most
frequently affected breeds, suggesting this is an inherited trait.
What are the signs of entropion?
Eyelids appear to roll inward
Excessive tearing
Winking/Squinting
Eyes will appear red
or inflamed
Holding the eye shut completely
Painful eyes causing dogs to paw and rub
Sensitivity to light
What are the risks of entropion?
Left
untreated, severe eye infections may develop. The cornea can become
severely irritated or damaged as the chronic abrasion by the
inverted lower lid wears away at its surface. In some cases, deep
ulcers form in the cornea, even to the point of rupturing through its
surface.
This quickly leads to intraocular infections and potential blindness.
What is the management?
Once diagnosed, surgery is the only treatment. There are several
different techniques, but typically, a small incision is made below the
lid, a small portion of skin is removed, and when the two sides of the
incision are then sutured, it pulls the border of the lid downward into
a normal position. Antibiotic ointments may be applied, if infections
are present.
Ectropion
Ectropion is used to describe a condition where the lower lids are
loose, causing a drooping of the eyelid's margins. The lower lids
actually turn outward. One or both eyes may be involved. It can occur
in any breed, but it is inherited in American Cocker Spaniels, Saint Bernards, Mastiffs, and Bloodhounds.
What are the signs of ectropion?
As the lower lid sags downward, the underlying conjunctiva
is exposed. This forms a pouch or pocket, allowing pollens, grasses,
dust, etc., to accumulate and rub against the sensitive conjunctiva.
This is a constant source of irritation in these dogs, leading to
increased redness of the conjunctiva and excessive watering of the
eye, which then spills out over the lower lid and face.
What are the risks of ectropion?
Many dogs live normal lives with ectropion. However, some develop
repeated eye infections due to the collection of dirt, dust, etc.,
within the eye. Therefore, the risks are minor except in severe cases,
where secondary eye infections may develop.
What is the management of ectropion?
Some dogs require no treatment; however, if eye irritations develop,
medical attention is advisable. Mild cases can be treated with eye
drops or salves to alleviate irritations and/or infections when they
occur. In severe cases, a surgical procedure is preferred, which
removes excess tissue, thereby tightening the lids and removing the abnormal pocket.
The conjunctiva is the pink tissue that lines
the inner surface of the eyelids and covers the front portions of the eyeball
except the clear transparent cornea. It is a protective layer that
contains special glands whose secretions help maintain normal eye health.
.
Conjunctivitis is used to describe the
conjunctiva when it becomes reddened, congested, and painful. It
may occur in one or both eyes, depending upon the cause. Causes of
conjunctivitis include:
- foreign material such as dust or pollen, or even larger particles - chemicals such as shampoo - infectious causes - bacteria, viruses, fungi or
others - polluted water - smoke
Other causes may be due to
birth defects, serious internal diseases, and allergic reactions.
.
Laboratory tests, including blood cell
counts, conjunctival scrapings and cultures, may be needed to help determine
the cause and therefore allow effective treatment. Attempts should be made to
prevent further irritation to your pet’s eyes from such things as contaminated
water, soap, dust, sprays, smoke, trauma, etc.
Treatment
usually consists of antibiotic drops or ointment, topical pain
relievers, and sometimes systemic or oral medications depending on the
underlying cause. Steroids may also be of benefit, but only if there is
not a corneal ulcer present.
Sudden
Acquired Retinal Degeneration Syndrome (SARDS) is a condition seen in
dogs which usually results in a rapid degeneration of the retina
leading to irreversible, complete vision loss over a few days to a few
weeks. The retina usually appears normal when initially examined
because the degeneration occurs so rapidly. Over time, the retina will
eventually show evidence of degeneration when examined.
What Causes SARDS?
The
cause of SARDS is unknown at this time. It has been shown that it is
not an inherited (genetic) disorder. It is currently thought that it
is a toxic reaction in the retina possibly related to fat by- products,
hormonal and immune-mediated causes.
What is a typical scenario?
The
disease normally occurs in middle-age to older dogs which are commonly
overweight. Female dogs are affected more often than male dogs. SARDS
may occur in any breed including mixed breed dogs, however, of the pure
bred dogs, dachshunds and schnauzers appear to be predisposed. The
disease is often associated with an increase in thirst, urination, and
weight gain. SARDS may be associated with Cushing’s disease,
a condition associated with overproduction of corticosteroids by the
adrenal gland. If symptoms are suggestive of Cushing’s disease blood
testing is recommended.
Diagnosis
SARDS
is usually confirmed by performing an electrical function test of the
retina called an Electroretinogram (ERG). Since the retina appears
normal on initial evaluation this test is necessary to distinguish SARDS
from other causes of blindness including central nervous system
disorders of the optic nerve or the brain. If a dog has SARDS, the ERG
will show an absence of retinal activity. If the retinal activity is
not extinguished, additional diagnostic testing may be required to
determine the cause of the blindness.
What is the treatment and what are the expectations?
There is no known treatment available for SARDS. This condition not a
painful disorder; pets remain comfortable and pain free. In pets that
are positive for Cushing’s disease, treatment of Cushing’s disease is
recommended because this disease can have adverse effects on other body
systems. Treatment of the Cushing’s disease will not improve vision. Since
pets with SARDS have rapid vision loss, initially adjustment to their
home environment takes a few weeks time to adapt to the changes. Pets’
strong sense of smell and memory and hearing are important during their
adaptive period.
If you think your pet has an ocular
emergency please call the Roslyn-Greenvale Veterinary Group at 516-621-4010 to schedule an appointment immediately.