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Cherry Eye and surgical correction

An Eye for Details

I like Elsa’s owners a lot. They are the kind of clients that you genuinely look forward to seeing when their name appears on the daylist. For her part, Elsa is also a star patient. I have encountered many dogs over the years and I have to say that there are few breeds that rival Cavaliers for temperament. Cavalier spaniels are very, very kind- natured dogs and always seem to have a slightly worried expression on their faces. I have never even been growled at by one of these dogs and after a few savagings this can really start to be an important breed characteristic.

As with many breeds these days these sweet- natured pooches have been twisted and changed over the years for the show ring and now have had various health problems bestowed on them by us wonderful human beings. The most worrying one is their almost inevitable development of mitral valve disease at some stage of their lives. There is a scheme in place to try to breed it out but as with all these things it does rely on EVERY breeder being responsible. Elsa has so far escaped this fate and I hope that she will continue to do so.

She has however been given the shortened face of a Cavalier and the bulging eyes that are so desired as the breed standard. In fact hers are some of the most bulbous I have seen. Elsa’s owners are more than aware of this and they in fact took her on because she was unwanted for showing, not being millimetre perfect. As we said recently after her surgery when we were mulling over the strange world of pedigrees, surely looks shouldn’t dictate how much a dog is loved?

Anyway, I digress. It was her eyes that had brought Elsa to me and to another vet a few months before. She had a condition called ‘cherry eye’. We see this most in Bulldogs but it is recognised fairly commonly in many short- faced breeds and is certainly an uncomfortable condition to put up with. As the name suggests the dogs develop a bulging mass in the corner of the eye that is reddened and resembles the cherry of the name.

This mass is in fact a gland that sits in the third eyelid. There are many glands around the soft tissue of the eye that are responsible for producing tears, the all- important lubricant required for healthy eyes. This gland in the third eyelid becomes prolapsed and bulges out over the cartilage rim, everting the lid and causing irritation. Elsa was periodically rubbing her face and making herself sorer because of the irritation. The added trauma had also produced a small ulcer on the cornea itself too.

Having tried, and failed, to get the gland to sit back in place we decided the best option was surgery to try and hold the gland back in and allow the swelling and inflammation to go down. There is an option to remove the gland but this is always left as a last resort because the gland is responsible for so much of the tear production. In a breed that are also prone to a horrible condition called dry eye the last thing we wanted to do was make that more likely.

I felt so guilty about what we had to do as I looked into Elsa’s incredibly trusting eyes as we gave her her anaesthetic injection and watched as she flopped onto her side. In all these cases it is important to focus on the fact that you are trying to help and will hopefully make a big difference to a dog’s quality of life. Perhaps I would have to perform fewer such operations if some of the breed standards didn’t demand such unnatural body shapes!

With Elsa asleep I embarked on some very intricate surgery. Jo, my trusty helper, held Elsa’s third eyelid out on some stay sutures to expose the inner surface of the lid and the gland itself. Next, I made an incision into the conjunctiva along the top of the gland and an equal incision underneath the gland right down in the depths of the eyelid. This effectively gave me a potential pocket to put my gland in. With some very small instruments, some very fine suture material and a very steady hand I then started to suture the gland in its new pocket. This was achieved by stitching the top of the top incision to the bottom of the bottom incision, pulling the conjunctival membrane over the gland and snaring it firmly in place.

Although the surgery is quite fiddly due to the size of the instruments needed and the location it is actually quite a straight- forward stitch- up! As Elsa started to come round I was pleased to see that there was absolutely no hint of the gland popping out. Some bleeding from the incisions at the time of the surgery had given a blood- shot look to a very sweet face but I knew her owners would simply be happy to have her home again. We sent Elsa home with a ‘lampshade’ collar to stop her rubbing her eye and causing any damage to the new repair.

At Elsa’s post- op check I asked her owners how she was getting on with the collar and they smiled indulgently and glanced at each other. I wondered if they were about to confess to not keeping it on out of a sense of guilt but I was wrong. They had been very good owners from my point of view and had diligently kept the bucket in place. The smiles were a gentle acknowledgement that Elsa had managed what most dogs do in the face of such adversity- she had unashamedly and openly manipulated her loving owners into doing everything for her and treating her like the special princess that she knows she is!

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