Bulldogs and Cherry Eye

Hi Everybody! It’s Me, Barkley!

Today I’d like to talk about a topic some bulldog owners are faced with, and that’s Cherry Eye. It can be quite alarming when you first see a Cherry Eye pop out in your dog’s eye, I know it was for me.

What is Cherry Eye:

The technical name for Cherry Eye is Prolapsed Nictitating Membrane Gland (PNMG), and brachycephalic breeds are 6.93 times more likely to develop it compared to non-brachycephalic breeds. Dogs and cats have a third eyelid. Cherry Eye occurs when one of the two tear glands positioned on the inner corner of a dog’s eye protrudes from behind the third eyelid. The prolapse occurs because of the weakness of the connective tissue that holds the gland in place. The gland becomes swollen and red, covering a portion of the inner eye.

How is it corrected:

The gold standard way to correct Cherry Eye is with corrective surgery. The surgery is simple and consists of repositioning the gland and tacking it back into place with a stitch or two. Basically, they make a pocket inside the third eyelid and suture the gland back into the pocket. Be aware there’s a small chance of the cherry eye popping back out after surgery. If this does occur, it may require a second surgery to reposition the gland again. In rare cases, repeated surgeries may make it necessary to remove the tear gland entirely, which should be a last resort as this could cause the dog to develop chronic dry eye¹.

A more detailed summary of Cherry Eye and why Bulldogs are susceptible to the condition:

A 2016 study conducted by VetCompass Programme in the UK, found that Brachycephalic breeds (flat-faced dogs) are 6.93 times more likely to develop PNMG (prolapsed nictitating membrane gland) compared to non-brachycephalic dogs. PNMG is commonly referred to as Cherry Eye. Cherry Eye occurs when one of the two tear glands positioned on the inner corner of a dog’s eye protrudes from behind the third eyelid. The gland becomes swollen and red, covering a portion of the inner eye, and requires surgical correction. Left untreated, it can lead to chronic conditions such as dry eye, corneal infection, eye ulceration, and long-term damage to the cornea. We’ll look deeper into this study to understand what this means for the Bulldog breed.

The one-year study followed the health records of 905,553 dogs at 887 vet clinics in the UK. They tracked the dog’s age, breed, sex, weight, neuter condition, and insurance status. Breed information was further broken down to look at purebred status, skull shape, and Kennel Club grouping.

Of the dogs followed in the study, 1,802 were identified to have PNMG (0.20%). The most common breed types among the PNMG cases were: English Bulldogs (N=446, 24.75%), crossbreed (N=292, 16.20%), French Bulldogs (N=200, 11.10%), and Lhasa Apso (N=199, 11.04%). The study found that purebred dogs are 1.43 times more likely to be diagnosed with Cherry Eye, and brachycephalic breeds are 6.93 times more likely compared to non-brachycephalic breeds. Additional findings concluded that dogs under 1 year had 10.82 times the odds compared to dogs who were 2-4 years old. Neutered animals had higher odds, and insured dogs were 1.89 times the odds of uninsured dogs.

It is believed that anatomical qualities of the skull formation in brachycephalic breeds are a contributing factor. The third eyelid is more easily prolapsed due to the inclined location of the third eyelid and smaller skull space.  The prolapse occurs because of the weakness of the connective tissue that holds the gland in place.

Corrective surgery is simple and consists of repositioning the gland and tacking it back into place with a stitch or two. There’s a 10% chance of the cherry eye popping back out after surgery. If this does occur, it may require a second surgery to reposition the gland again. In rare cases, repeated surgeries may make it necessary to remove the tear gland entirely, which should be a last resort as this could cause the dog to develop chronic dry eye¹.

In conclusion, if you have a brachycephalic dog such as an English or French bulldog, there is a small chance of developing Cherry Eye. Don’t panic, cherry eye can be corrected with a relatively simple surgery.

Citations:

1. Martin, Rebecca. 2021, Feb 9. How to treat cherry eye in dogs. https://vethelpdirect.com/vetblog/2021/02/09/how-to-treat-cherry-eye-in-dogs/
2. O’Neill DG, Yin Y, Tetas Pont R, Brodbelt DC, Church DB, Pegram C, et al. (2022) Breed and conformational predispositions for prolapsed nictitating membrane gland (PNMG) in dogs in the UK: A VetCompass study. PLoS ONE 17(1): e0260538. https://doi.org/10.1371/journal.pone. 0260538. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0260538