Midge is a 5 year old, spayed female, Yorkshire Terrier mix that has had prolapsed glands of the third eyelid for 3 years. The prolapsed gland (also known as Cherry Eye) appears as small red masses that protrude from behind the third eyelid. This gland is vital for proper tear production and lubrication of the eye. The gland prolapses due to a congenital weakness in the musculature that holds the gland in place. In the vast majority of cases, surgical replacement is required.
Surgical replacement of the prolapsed glands of the third eyelid was reviewed with Midge’s family in detail, before proceeding with surgery. Dr. Warren opted to use the Modified Morgan Pocket technique, as this technique allows the third eyelid to move normally after surgery. Removal of this important gland is not recommended, due to the potential for long term consequences, including chronic dry eye.
It is important to note that surgical treatment for dogs with nictitans gland prolapse of several months’ duration has a less favourable prognosis for success. We fully discussed the benefits of surgery with the owners and the possibility of unsuccessful results. We always approach these cases with a favourable outlook and with the goal of excellent results. Surgery was performed in our surgical suite at Southdown Animal Clinic (our Mississauga Hospital) on October 07, 2016.
Things that must be considered for a successful outcome:
- Schirmer tear test-that measures that for adequate tear production is still good ( greater than 16 mm/minute )
- Use of topical steroids for 1 to 3 months to reduce inflammation and swelling of the nictitans gland before surgery.
- The sooner surgery is done after obvious prolapse of the glands the higher the success rate. We are always reluctant to unequivocally state that something is beyond hope no matter how chronic. There are a tremendous number of variables that enter into the picture.
- Attention to detail in surgery
- The body’s ability to heal
- With the Pocket Technique once the gland stays down for 30 days then it most likely will stay down permanently
- The breed of dog maybe a factor; e.g. the British Bulldog may have a higher failure rate
The owners comments on the last follow up at 6 weeks post surgery: “It is the first time in many months that Midge has been able to sleep with her eyes closed!”