Cherry Eye

Cherry eye is a common ocular condition in dogs characterized by the prolapse or protrusion of the gland of the third eyelid, also known as the nictitans gland or nictitating membrane gland. Dogs have a third eyelid, the nictitating membrane, located in the inner corner of each eye, which contains a tear-producing gland that contributes significantly to the eye's tear film. When the connective tissue holding this gland in its normal position weakens or fails, the gland pops out from behind the third eyelid and becomes visible as a pink or red, oval-shaped mass at the inner corner of the eye. The condition gets its name from the resemblance of the prolapsed gland to a small cherry. Cherry eye is most commonly seen in young dogs, typically developing within the first two years of life, and certain breeds are particularly predisposed.

The underlying mechanism of cherry eye involves weakness or congenital absence of the connective tissue attachments that normally anchor the nictitans gland behind the third eyelid. In healthy dogs, the gland is firmly attached to the orbital rim by fibrous connective tissue and remains hidden from view. When these attachments are weak, which is thought to be a hereditary trait in predisposed breeds, the gland can pop out of position, particularly when the dog is excited, stressed, or the eye is irritated. Once prolapsed, the exposed gland becomes swollen and inflamed from exposure to air and irritants, making it appear larger and redder than normal. The condition may affect one eye initially, but bilateral involvement occurs in a significant percentage of cases.

The impact of cherry eye on affected dogs extends beyond cosmetic concerns to potential effects on eye health and comfort. The nictitans gland produces approximately thirty to fifty percent of the aqueous portion of the tear film, making its proper function essential for maintaining eye lubrication. A chronically prolapsed gland may become damaged and produce fewer tears, potentially leading to dry eye later in life. The exposed, inflamed gland can cause discomfort, leading dogs to paw at their eyes or rub their faces. Secondary conjunctivitis and eye irritation commonly accompany the prolapse. While cherry eye itself is not a medical emergency, prompt veterinary attention helps ensure appropriate treatment and the best long-term outcomes for eye health.

Treatment for cherry eye has evolved significantly over the years, with modern surgical techniques focusing on preservation and repositioning of the gland rather than removal. Surgical correction is the treatment of choice and typically involves repositioning the gland to its normal location and securing it with sutures using one of several established techniques. When performed by an experienced surgeon, these procedures have high success rates and preserve the gland's tear-producing function. Early surgical intervention, before chronic changes develop in the gland, generally offers the best outcomes. Dogs that have undergone successful cherry eye surgery typically go on to have normal eye health, though follow-up monitoring is recommended to watch for recurrence or development of dry eye.

The primary cause of cherry eye is weakness or congenital absence of the connective tissue attachments that normally hold the nictitans gland in its proper position behind the third eyelid. In healthy dogs, fibrous tissue firmly anchors the gland to the periorbital tissues, preventing prolapse. Dogs that develop cherry eye are thought to have inherent weakness in these attachments, likely due to developmental abnormalities or inherited connective tissue characteristics. This anatomical predisposition explains why certain breeds are much more commonly affected than others and why the condition typically appears early in life rather than developing as dogs age. The weakness may be present from birth, with prolapse occurring when triggered by various factors.

Genetic and hereditary factors play a significant role in the development of cherry eye, as evidenced by strong breed predispositions. Brachycephalic breeds, those with shortened skulls and prominent eyes, show particularly high incidence, suggesting that skull and orbital anatomy may contribute to the condition. The familial nature of cherry eye within breed lines further supports hereditary transmission, though the specific mode of inheritance has not been definitively characterized. Puppies from parents or siblings with cherry eye have increased risk, making family history a relevant consideration for breeders and puppy buyers. The concentration of cases in certain breeds despite the condition being physically treatable underscores the genetic component.

Environmental and lifestyle factors may trigger prolapse in dogs with underlying anatomical predisposition but are not primary causes of the condition. Anything that causes swelling or inflammation of the eye area may precipitate prolapse in a susceptible dog. Allergic reactions, eye infections, or irritation from foreign material can potentially trigger the initial prolapse. Excitement, stress, or physical activity might also be associated with the timing of prolapse in some cases. However, these factors would not cause cherry eye in a dog with normally attached glandular tissue. Once prolapse has occurred, continued exposure and inflammation maintain the visible protrusion and may worsen the appearance over time.

Risk factors for cherry eye are dominated by breed background and age. Bulldogs, including English Bulldogs, French Bulldogs, and American Bulldogs, have extremely high incidence. Beagles, Cocker Spaniels, Lhasa Apsos, Shih Tzus, Boston Terriers, Bloodhounds, Neapolitan Mastiffs, and other brachycephalic or hound breeds are also commonly affected. Young dogs are at highest risk, with most cases developing between three months and two years of age. Cherry eye is relatively rare in older dogs that have not previously had the condition. Dogs that develop cherry eye in one eye have significant risk of eventual bilateral involvement, though this may occur weeks to months after the initial prolapse.

The mechanism by which cherry eye develops involves the physical displacement of the gland from its normal concealed position. When the supporting connective tissue fails, the gland is pushed forward by normal eye movements and blinking, eventually popping out from behind the leading edge of the third eyelid. Once exposed, the gland tissue swells due to impaired venous and lymphatic drainage, and the surface becomes irritated from exposure. This swelling makes spontaneous return to normal position increasingly unlikely the longer the prolapse persists. Chronic prolapse can lead to permanent changes in the gland tissue, potentially affecting its tear-producing capacity. These progressive changes emphasize the importance of timely surgical correction.

The early warning signs of cherry eye may be subtle and intermittent before the obvious prolapse becomes permanent. Some owners notice that the third eyelid seems more visible than usual at certain times, particularly when the dog is relaxed or waking from sleep. A pink or reddish tissue may briefly appear at the inner corner of the eye before receding again. Dogs may show mild signs of eye irritation such as blinking, squinting, or occasional pawing at the eye. Some dogs have multiple brief episodes of prolapse before the gland remains permanently displaced. These intermittent early signs are often missed or attributed to minor eye irritation, with owners typically seeking veterinary attention only when the prolapse becomes constant and obvious.

The most distinctive and immediately recognizable symptom of cherry eye is the visible pink or red mass protruding from the inner corner of the affected eye. This mass is typically oval or bean-shaped and may range from the size of a small pea to considerably larger depending on the degree of swelling. The color ranges from pink to deep red, with more inflamed glands appearing darker. The mass is located at the junction between the third eyelid and the lower eyelid, often partially covering the inner portion of the eye. In mild cases, the prolapse may be small and only intermittently visible. In severe cases, the swollen gland may be large enough to partially obscure vision. The characteristic appearance is unmistakable and is what gives the condition its common name.

Behavioral changes in dogs with cherry eye reflect the discomfort and irritation caused by the exposed glandular tissue. Dogs often paw at the affected eye, sometimes excessively, which can worsen irritation and cause self-trauma. Rubbing the face against furniture, carpeting, or the ground is common as dogs attempt to relieve the sensation of irritation. Some dogs become head-shy or resistant to having their face touched. Changes in activity level may occur if the condition causes significant discomfort. Dogs with bilateral cherry eye may show more pronounced behavioral changes than those with unilateral involvement. These behavioral responses, while understandable, can potentially cause additional damage and should be addressed through appropriate treatment.

Physical signs accompanying cherry eye include various manifestations of eye irritation and inflammation. Conjunctivitis, or inflammation of the conjunctival membranes lining the eye, commonly develops secondary to the prolapse. This appears as redness of the visible eye membranes beyond just the prolapsed gland. Excessive tearing or abnormal discharge may occur, ranging from clear and watery to mucoid or purulent if secondary infection develops. The eye may appear irritated with visible blood vessels on the white portion of the eye. Squinting or keeping the eye partially closed indicates discomfort. In longstanding cases, changes in tear production may lead to corneal dryness, though this is more commonly a later complication than an initial presenting sign.

Symptom progression in cherry eye typically involves the prolapse becoming larger and more consistently visible if left untreated. Initial prolapses may be small and intermittent, but the gland typically becomes more swollen and remains prolapsed over time. The color may become deeper red or even purplish as inflammation and congestion increase. Secondary changes such as thickening of the gland surface and chronic conjunctivitis develop with prolonged exposure. If the second eye is going to be affected, symptoms typically develop within months of the first eye, though occasionally the interval is longer. Without surgical correction, the chronic changes in the gland may eventually lead to decreased tear production and dry eye syndrome.

Emergency symptoms related to cherry eye are uncommon, but certain situations warrant urgent veterinary attention. If a dog traumatizes the eye through aggressive rubbing or pawing, corneal damage requiring immediate care can occur. Signs of corneal ulceration include severe squinting, excessive tearing, visible cloudiness or irregularity of the corneal surface, and apparent pain. Eye discharge that becomes thick, yellow, or green suggests secondary infection requiring treatment. Sudden worsening of appearance or development of symptoms in a previously treated eye warrants prompt evaluation. While cherry eye itself is not an emergency, these complications require timely veterinary attention to prevent permanent damage to vision or eye health.

The initial examination for cherry eye is typically straightforward, as the condition has a characteristic appearance that is recognizable on visual inspection. The veterinarian will observe the protruding pink or red mass at the inner corner of the eye and confirm that it represents the prolapsed third eyelid gland. A complete ophthalmic examination assesses the overall health of the eye, including evaluation of the cornea for any damage, assessment of tear production, measurement of intraocular pressure, and examination of the internal structures of the eye. The veterinarian will examine both eyes, as bilateral involvement may be present or developing. History regarding the onset, duration, and any previous treatment attempts provides useful information.

Diagnostic tests for cherry eye focus on evaluating the overall health of the affected eye and checking for any secondary complications. The Schirmer tear test measures tear production and establishes a baseline that can be compared to post-treatment values. Fluorescein staining of the cornea checks for any ulceration or damage that might have occurred from irritation or self-trauma. Tonometry measures intraocular pressure to rule out glaucoma, which can occasionally occur concurrently with third eyelid abnormalities. These tests are quick, non-invasive, and provide important information about eye health. In most cases, the diagnosis is made based on the characteristic clinical appearance without need for additional testing.

Imaging studies are rarely necessary for diagnosing cherry eye but may be useful in atypical presentations or to evaluate for concurrent conditions. Ocular ultrasound can assess the structures behind the eye if there is concern about orbital disease. Advanced imaging such as CT or MRI would only be indicated if the clinical picture suggests more complex orbital or neurological involvement, which is uncommon in straightforward cherry eye. The diagnosis is primarily clinical, based on the unmistakable appearance of the prolapsed gland, and most dogs do not require imaging studies for diagnosis or treatment planning.

Differential diagnosis of masses at the inner corner of the eye includes conditions other than cherry eye that could present similarly, though these are less common. Tumors of the third eyelid or surrounding tissues can occasionally appear as masses in this location, though they typically occur in older dogs and have different characteristics on examination. Inflammatory conditions of the third eyelid can cause swelling that might initially resemble cherry eye. Foreign body reaction or trauma to the third eyelid area could cause localized swelling. Scrolling of the third eyelid cartilage is a different condition that can cause third eyelid prominence. Experienced veterinarians can typically distinguish cherry eye from these alternatives based on the clinical appearance, patient age and breed, and response to manipulation. In unusual cases, biopsy of the tissue may be warranted to confirm the diagnosis.

Immediate treatment for newly diagnosed cherry eye focuses on protecting the eye and reducing inflammation while planning for definitive surgical correction. Topical lubricating drops help keep the exposed gland moist and comfortable. Anti-inflammatory medications, either topical eye drops or oral medications, reduce swelling and discomfort. An Elizabethan collar prevents the dog from pawing at or rubbing the eye, which could cause additional trauma. Some veterinarians recommend gentle massage to attempt manual repositioning of the gland in very recent prolapses, though this is rarely successful as a long-term solution. These conservative measures provide symptomatic relief but are not substitutes for surgical correction.

Medical management alone is not considered appropriate long-term treatment for cherry eye, and surgical correction is the treatment of choice. However, medical therapy may be used temporarily in situations where surgery must be delayed. Topical lubricants applied frequently help protect the exposed gland. Anti-inflammatory drops reduce swelling and irritation. Treatment of any secondary bacterial infection with antibiotic drops may be necessary. These measures can help maintain the gland in reasonable condition until surgery can be performed, but they do not address the underlying anatomical problem. The longer surgical correction is delayed, the more chronic changes develop in the gland, potentially affecting long-term outcomes.

Surgical correction of cherry eye aims to reposition the prolapsed gland to its normal anatomical position and secure it to prevent recurrence while preserving the gland's tear-producing function. Several surgical techniques are commonly used, including the pocket technique, where the gland is tucked into a surgically created pocket in the conjunctiva, and anchoring techniques that suture the gland to orbital structures. The specific technique chosen depends on surgeon preference, experience, and individual case characteristics. Surgical removal of the gland was once commonly performed but is now strongly discouraged because it significantly increases the risk of dry eye later in life. Experienced surgeons achieve success rates of eighty to ninety percent or higher with gland-preserving techniques.

Supportive care following cherry eye surgery is essential for optimal healing and outcomes. An Elizabethan collar is mandatory for approximately two weeks to prevent the dog from rubbing or traumatizing the surgical site. Topical antibiotic drops prevent infection during healing. Anti-inflammatory medications control postoperative swelling and discomfort. Activity restriction helps prevent increased pressure on the surgical repair. The eye should be monitored closely for any signs of complications such as infection, suture problems, or early recurrence. Follow-up examination allows the veterinarian to assess healing and remove sutures if non-absorbable materials were used. Most dogs heal well with appropriate postoperative care.

Alternative and complementary approaches to cherry eye treatment are limited, as surgical correction is definitively required for long-term resolution. Some owners inquire about natural treatments or home remedies, but these cannot correct the underlying anatomical abnormality. Keeping the eye lubricated and comfortable provides supportive care but does not address the prolapse. Massage and gentle manipulation may temporarily reposition the gland in very early cases but rarely provide lasting correction. Any delay in pursuing surgical treatment allows progressive damage to the gland, potentially compromising long-term tear production. The most effective approach is timely surgical correction by an experienced veterinary ophthalmologist or surgeon.

Treatment decisions for cherry eye should consider the importance of gland preservation, choice of surgeon, and timing of surgery. Owners should understand that gland removal, while technically simpler, carries significant risk of future dry eye and should be avoided. Referral to a veterinary ophthalmologist may be advisable for optimal outcomes, particularly in breeds with high recurrence rates or for revision surgery after failed initial repair. Prompt surgical correction, before chronic changes develop in the gland, offers the best chance for complete restoration of normal function. Costs vary depending on the surgeon, geographic location, and whether one or both eyes require treatment. Discussing expectations, potential complications, and long-term monitoring needs helps owners make informed decisions.

The recovery timeline following cherry eye surgery is generally straightforward, with most dogs healing well within two to three weeks. Immediately after surgery, the eye typically appears red and swollen, which is normal and expected. Swelling gradually decreases over the first week, and the eye begins to look more normal. The repositioned gland settles into its corrected position as healing progresses. Complete healing of the surgical site typically occurs within two to three weeks, though complete resolution of all postoperative changes may take slightly longer. During the recovery period, strict adherence to activity restrictions and medication schedules is essential for optimal outcomes.

Post-treatment care requirements are straightforward but must be followed carefully to prevent complications. The Elizabethan collar must be worn continuously for the prescribed period, typically two weeks, to prevent the dog from rubbing the eye. Topical medications, usually antibiotic and anti-inflammatory drops, are administered several times daily according to the prescribed schedule. Activity should be restricted, avoiding rough play, running, and any activities that might increase pressure on the eye. The eye should be kept clean, and any discharge gently wiped away with a clean, damp cloth. Follow-up appointments allow the veterinarian to monitor healing and identify any problems early.

Prognosis following cherry eye surgery is generally excellent when the procedure is performed by an experienced surgeon and postoperative care is followed appropriately. The gland repositions successfully and resumes normal tear production in the vast majority of cases. However, recurrence of prolapse can occur in five to twenty percent of cases, depending on the surgical technique used and individual patient factors. Dogs that experience recurrence may require repeat surgery, often with a different technique. Long-term monitoring of tear production is recommended because dry eye can develop months to years after surgery, particularly if the gland was damaged from prolonged prolapse before treatment. Early surgical intervention generally offers better long-term prognosis.

Long-term outlook for dogs after successful cherry eye surgery is favorable, with most dogs enjoying normal eye health throughout their lives. Regular monitoring of tear production through periodic Schirmer tear tests allows early detection of any decrease in tear production. Dogs that develop dry eye can be managed successfully with artificial tear supplements and other treatments. The risk of cherry eye in the other eye should be considered, as bilateral involvement is common. Dogs that have had cherry eye surgery can participate in normal activities once healing is complete, with no long-term restrictions. Overall, with appropriate treatment and monitoring, cherry eye is a highly manageable condition with excellent outcomes.

Primary prevention of cherry eye is challenging because the underlying weakness in connective tissue attachments is congenital and not modifiable through lifestyle changes. There are no proven methods to prevent cherry eye from occurring in dogs with anatomical predisposition. Avoiding activities that cause excessive eye swelling or irritation might theoretically reduce the likelihood of triggering prolapse in a susceptible dog, but this is speculative and difficult to implement practically. The most effective prevention strategy focuses on breed selection and responsible breeding practices that may reduce the prevalence of the condition in future generations.

Breeding considerations are central to reducing the incidence of cherry eye in predisposed breeds. Dogs that have had cherry eye should ideally not be bred, as they may pass the predisposition to offspring. Close relatives of affected dogs should be bred cautiously, if at all, as they may carry the genetic factors that contribute to the condition. Breeders should track the incidence of cherry eye in their lines and select breeding stock from families with lower incidence. While no genetic test exists for cherry eye susceptibility, phenotypic selection against affected individuals can help reduce breed prevalence over time. Responsible breeders prioritize health and work to reduce inherited conditions in their breeding programs.

Nutritional and environmental considerations do not directly prevent cherry eye, though maintaining overall eye health supports optimal outcomes if the condition does occur. Ensuring adequate nutrition supports healthy connective tissue development. Avoiding eye irritants and promptly treating any eye infections or allergies minimizes inflammation that might theoretically trigger prolapse in a susceptible dog. Keeping eyes clean and protected during activities that might cause injury or irritation is generally good practice. These measures support overall eye health rather than specifically preventing cherry eye.

Health maintenance practices focus on early detection and prompt treatment rather than prevention per se. Owners of predisposed breeds should be educated about the appearance of cherry eye so they can recognize it promptly if it develops. Regular veterinary examinations include assessment of eye health and third eyelid position. If one eye develops cherry eye, the owner should watch the other eye closely, as bilateral involvement is common. Prompt surgical correction when cherry eye does occur prevents long-term complications and offers the best outcomes.

Early intervention when cherry eye first appears significantly impacts long-term outcomes. The sooner surgical correction is performed after prolapse occurs, the better the chances for complete restoration of normal gland function and tear production. Chronic prolapse allows progressive damage to the gland from exposure and inflammation. Owners who notice the characteristic pink or red mass at the inner corner of their dog's eye should seek veterinary attention promptly. Early surgery, before significant gland damage has occurred, offers the best prognosis for preservation of normal tear production and overall eye health.

Daily management of dogs during the recovery period after cherry eye surgery requires attention to medication schedules and activity restrictions. Topical medications must be administered at the prescribed intervals, which typically means drops several times daily. Establishing a routine for medication administration helps ensure consistency. The Elizabethan collar must remain in place at all times, even during sleep and eating, to prevent the dog from rubbing the eye. Activity should be kept calm and controlled, avoiding rough play, running, and interactions with other dogs that might result in accidental eye trauma. Monitoring the eye for any changes in appearance or discharge allows early detection of any complications.

The home environment during recovery should be adapted to accommodate the Elizabethan collar and support comfortable healing. Food and water bowls may need to be elevated or widened to allow the dog to eat and drink comfortably with the collar in place. Furniture placement may need adjustment to allow the dog to navigate safely with the collar. A quiet, comfortable resting area away from household activity helps the dog relax. Other pets in the household should be monitored during interactions to prevent accidental bumping of the affected eye. These temporary modifications support smooth recovery and help the dog remain comfortable.

Maintaining quality of life after recovery from cherry eye surgery is straightforward, as most dogs return to completely normal activities once healing is complete. No long-term activity restrictions are necessary after successful surgical recovery. Dogs can participate in all normal activities including swimming, which is sometimes a concern for owners. The eye should look normal, with the third eyelid in its proper position and the gland no longer visible. Owners can feel confident that their dog's eye health has been restored. The only ongoing requirement is periodic monitoring of tear production to ensure the gland continues functioning normally.

Ongoing monitoring and veterinary care after cherry eye surgery include periodic checks of tear production using the Schirmer tear test. The veterinarian may recommend testing every six to twelve months initially, with longer intervals once stable tear production is confirmed. Watching for signs of dry eye, such as thick mucoid discharge, redness, or cloudiness of the cornea, allows early detection of any decrease in tear production. If the other eye has not yet been affected, owners should remain vigilant for signs of cherry eye development. Reporting any concerns about eye health to the veterinarian promptly ensures timely intervention if problems arise.

Caregiver support for owners of dogs with cherry eye benefits from understanding that this is a very treatable condition with excellent outcomes. Initial distress at seeing the protruding gland is understandable, but owners can be reassured that surgery is highly successful. Connecting with breed-specific communities often provides support from others who have navigated the same experience. Understanding the importance of gland-preserving surgery helps owners advocate for appropriate treatment. Following through with postoperative care requirements and monitoring demonstrates commitment to the dog's long-term health. Most owners find that once the initial treatment period is complete, cherry eye becomes a minor footnote in their dog's health history.

Brachycephalic breeds demonstrate the highest risk for cherry eye, likely due to their distinctive skull and orbital anatomy. English Bulldogs have extremely high incidence, with some estimates suggesting the condition affects fifteen to twenty percent or more of the breed. French Bulldogs, increasingly popular, also show very high rates of cherry eye. Boston Terriers, Pugs, Pekingese, and other flat-faced breeds are commonly affected. The relationship between brachycephalic anatomy and cherry eye susceptibility is thought to involve the shallow orbital structure and prominent eye position characteristic of these breeds, which may place additional stress on the tissues supporting the third eyelid gland.

Other breeds with elevated risk for cherry eye include Beagles, Cocker Spaniels, Lhasa Apsos, Shih Tzus, Bloodhounds, Basset Hounds, Neapolitan Mastiffs, Cane Corsos, and other breeds with prominent eyes or loose facial skin. The condition also occurs in Cavalier King Charles Spaniels at higher than average rates. Giant breeds including Great Danes and Mastiffs are represented among affected dogs. Mixed breed dogs can develop cherry eye, particularly those with ancestry from predisposed breeds. The wide range of affected breeds suggests that multiple genetic factors may contribute to susceptibility, with different mechanisms potentially operative in different breed groups.

Screening recommendations for breeds at risk emphasize awareness and early intervention rather than predictive testing. Owners of predisposed breeds should be educated about cherry eye and instructed to seek veterinary attention promptly if the characteristic appearance develops. Breeders should track incidence in their lines and avoid breeding affected dogs. Puppies from high-risk breeds should have their eyes examined regularly as part of routine puppy care, particularly during the first two years of life when cherry eye most commonly appears. Puppy buyers should inquire about cherry eye history in the parent dogs and their relatives. While the condition cannot be prevented in predisposed individuals, early recognition and treatment optimize outcomes.

Conditions commonly associated with cherry eye include other ophthalmic problems that may occur concurrently or as sequelae. Keratoconjunctivitis sicca, commonly known as dry eye, is the most significant related condition, developing in dogs whose third eyelid gland has been removed rather than repositioned or in cases where the gland is damaged from prolonged prolapse. Dry eye requires lifelong management with lubricating medications and can lead to chronic eye discomfort and corneal disease if not properly treated. This relationship between cherry eye and dry eye underscores the importance of gland-preserving surgical techniques. Dogs with successfully treated cherry eye should have tear production monitored long-term.

Conditions with similar symptoms to cherry eye primarily involve other abnormalities of the third eyelid or masses at the inner corner of the eye. Third eyelid cartilage scrolling causes the third eyelid to fold abnormally, creating visible prominence that might initially resemble cherry eye. Tumors of the third eyelid can occur, particularly in older dogs, and require different treatment. Prolapse of the fat pad behind the eye can sometimes be confused with cherry eye by inexperienced observers. Inflammatory conditions affecting the third eyelid may cause swelling that mimics glandular prolapse. Veterinary examination readily distinguishes among these conditions based on careful assessment of the anatomy and tissue characteristics.

Potential complications of cherry eye include both direct consequences of the condition and complications of treatment. Corneal damage from chronic irritation or self-trauma can occur if the dog rubs at the eye excessively. Secondary bacterial conjunctivitis may develop when the exposed gland becomes colonized with bacteria. Chronic changes in the gland from prolonged exposure can impair its ability to produce tears normally. Surgical complications, though uncommon with experienced surgeons, can include infection, suture reaction, and failure of the repair with recurrence of prolapse. Early treatment minimizes most of these risks and offers the best long-term prognosis for maintaining normal eye health.