Cherry eye is a prolapse of the third eyelid's tear gland. The gland slips out of position and bulges as a red, fleshy mass in the inner corner of the eye. It looks alarming the first time you see it. It is very rarely an emergency.
The condition is common in bulldog breeds, including OEBs. It usually shows up before age 2 and often before age 1. About a third of cases occur bilaterally - both eyes, either at once or weeks apart.
What you should know first. Cherry eye is uncomfortable but it is not painful and it does not threaten the dog's vision. You have time to get a proper veterinary opinion. Don't panic. Don't try to push it back yourself.
Why it happens
The third eyelid's tear gland is held in place by a fibrous attachment. In bulldog breeds, that attachment is sometimes weaker than it should be, and a coughing fit, rough play, or just the routine pressure of waking up can pop the gland out of position.
Once it's out, the gland gets irritated, swells, and won't easily go back on its own. A small percentage spontaneously resolve in the first 24-48 hours. Most don't.
Treatment
The right fix is surgical replacement of the gland - also called tacking, anchoring, or pocket technique. The surgeon makes a small pocket in the third eyelid, tucks the gland into it, and sutures it closed. Recovery is fast (10-14 days). Recurrence rate is in the 5-15% range depending on technique and the surgeon's experience.
Cost: typically $400-$900 per eye at a general practice, $800-$1,500 at a board- certified veterinary ophthalmologist. The ophthalmologist is worth it for bulldogs.
Why you shouldn't remove the gland
Decades ago, the standard fix was to surgically remove the prolapsed gland - quick, cheap, "fixed." Don't accept this if a vet offers it.
The third eyelid's gland produces 40-50% of the dog's tear film. Removing it dramatically increases the risk of keratoconjunctivitis sicca (dry eye) later in life. Dry eye is much harder to manage than the original cherry eye and requires lifelong daily medication.
If a vet recommends gland removal, ask for a referral to an ophthalmologist for the replacement procedure instead.
What to do when it happens
- Don't panic. Take a clear photo for the vet.
- Call your regular vet within 24-48 hours for an exam.
- Apply a vet-prescribed lubricating ophthalmic ointment if it's going to be more than a few hours before the exam.
- Don't let the dog rub the eye - soft cone or T-shirt collar.
- Schedule the replacement surgery as soon as the swelling is manageable. Most vets prefer a few days of anti-inflammatory eye drops first.
If it recurs
The original surgery has a small failure rate. If the gland re-prolapses, the second surgery is harder and should be done by a board-certified ophthalmologist. The combination of pocket-and-tack-and-orbital-rim-anchor used by ophthalmologists has near-zero recurrence in their hands.
Should you ask the breeder?
Cherry eye has a heritable component but it isn't strongly enough heritable to eliminate from breeding. Most reputable OEB breeders have produced an occasional cherry-eye puppy. A breeder claiming "never had a cherry eye in 15 years of breeding" is either lucky or lying.
Reasonable question: "How often have your previous puppies had cherry eye, and did you cover the surgery?" Some breeders include cherry eye in their health guarantee for the first year. Some don't. Contract guide.