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Natalia Means
Cherry eye correction overview on the Neapolitan Mastiffs  

The canine has a third eyelid, which is located within the eye orbit in the inner corner of the nasal base of the dog`s eyes.
   The third eye has several names: Harderian gland, Harder`s gland, eye gland, nictitating membrane, nictitans gland, cherry eye, haw or in medical terms
glandula palpebrae tertiae superficials or profunda.
   The gland was discovered in the red deer by the Swiss physician Harder (1694). It was subsequently found  in amphibians, reptiles,birds and mammals.
   In Neapolitan Mastiffs this gland is not strongly held in place, which is leading to the prolapse of the gland, what we usually call "the cherry eye".
   "Cherry eye" or the prolapse of the Harderian gland is a picturesque term for everted third lid, when the ventral pink lobe of the gland prolapses appearing like a cherry in the corner of the eye (if in smaller version), or around the orbital venous sinus, covers a cornea entirely.
   The third eyelid evertion usually happens on the Neapolitan Mastiff puppies or young dogs around  8-12 weeks old or/and up to 12 months old.
   Unfortunately, the Neapolitan Mastiff breed is affected with this issue in the very high percentage, a very small % of mastini never have a cherry eye, some  have only one eye affected, and the majority have got to experience the prolapse of the gland on both eyes, where the gland on the second eye can pop up in a couple days or within next few months (up to year) after the first eye prolapsed.
   What causes the problem is not known, on the Neapolitan Mastiff was guessed is because of they have a lot of facial skin (wrinkles), which is very doubtful (that the wrinkles are to blame for), many mammals of different kind and families (in animalia), for example, rabbits and deers, develop it. It is suspected that the cause is the weakness of the connective tissue around the gland. The gland starts to move, irritates itself and the eye cornea , leads to swelling, discharge. The cherry eye must be taken care of as soon as possible (if not immediately). The gland can become bloody and develop a follicular conjunctivitis.
   Back in time, in many dog breeds, affected with the issue, the everted third lid was taken out (removed) surgically as "useless" tissue in the eye.
   Even though the dog breeders in the other breeds have progressively accepted and moved towards the idea of the preservation of the gland, the Neapolitan Mastiff breeders still at the strong belief  that the gland must be removed without a consideration of another option.
   It happened that the third eyelid got removed earlier, because back then was not known the full significance of it and it`s function in the dog`s eyes.
   The Harderian gland is responsible for about 30% of the eye`s  tear production. The tears are absolutely necessary  for the normal eye functioning to be healthy (not infected, not "dry"). The tears is what cleans the eyes, flashes away all the dust and dirt, protecting, keeping cornea clean and healthy. If there are not enough tears in the dog`s eyes, the eyes` functioning gets affected (becomes abnormal), as a result it leads to many different ocular problems, one of them is KCS - Keratoconjunctivitis sicca or "Dry Eye".
   KCS is a serious eye condition, requires the specific treatment for the rest of the dog`s life time, which eventually will make a dog blind anyway.
  Nowadays the ophthalmologists and the veterinarian practitioners do not recommend to remove the gland and prefer to preserve it, trying to avoid the compromising of the tear function, keeping in mind that if the other tear reproducing source ever fails due to trauma, infection, auto-immune disorders, the Harder`s gland will be of the benefit to the eyes, generally will work as a back up source, preventing the eyes from blindness.
   Today a few new advanced surgical techniques are offered on how to preserve the nictitating membrane instead of removing it. When it is done correctly by the experienced veterinarian specialist, it works on the Neapolitan Mastiff.
   Three my bred Neapolitan Mastiff puppies have the cherry eyes preserved, corrected using the "Morgan Pocket" technique (the gland replacing into it`s proper position/ tacked down), it has worked since.
   "Morgan Pocket" is a new technique of replacing the gland into it`s position - doing 2 incisions, placing the gland down inside of the gap between the incisions (like in the pocket), and stitch closing up "the pocket" with the gland inside of it. The stitches eventually dissolve, the swelling gets down and the gland is held down in place. Takes 1-4 weeks for healing process.
   However, should I note that the procedure of cherry eye correction was done on three dogs so far where none of them have any other eye issues (from the line not affected by entropion, dermoid or ectropion).
  I would like also to share the information that another two my bred Neapolitan Mastiff puppies, who at age of 6-7 months old, after playing hard ("diving" into snow / sand) developed the cherry eye. Their owners with the patience had to use eye drops 3 times a day and massage the gland back down (trying to place it back into it`s position with the fingers, massaging), after one week only doing it on the regular basis, the glands stopped to swim out, started to stay in the proper position and still no  complaints. Generally they placed the glands into it`s position without oral medication or surgery involvement. The glands are in place, the owners only trying not to allow another "diving" into snow or sand till the dog is 15-18 months old, almost is grown, so the connective tissue around the gland is not as weak as on the growing puppy.
   However, on a few other my bred puppies in past was prepared tacking the
gland procedure which did not work. That technique is when the gland pushed back down and only 1 stitch placed, which in my opinion is not enough for the size of the gland on the Neapolitan Mastiff to be held in place.
   I believe that that this technique is clearly not good enough for the Neapolitan Mastiff big sized gland, would not work, the gland would have too big area to swim back out destroying that one stitch or not.
   The cherry eye can be of the different sizes, the Neapolitan Mastiff is known to have a big gland, which is not "just in the corner" of the eye, but covers the entire front side of the eye cornea, there is no way one stitch in the corner could hold this huge gland in place, it will roll up again, whether breaking the stitch or not.
  Another technique " Orbital" was done to correct the cherry gland on a few puppies in Spain, which did not work, but from what I ve seen on the puppies right after the surgeries done, I assume that the practitioner did a very bad work with the correction procedure, on two dogs the glands did not even stay in place for a few hours and popped up again. On one puppy at age of 9 weeks old the glands were slit, spread around of the front side of the cornea and stitched. The stitches were pulling the eye cornea in the different directions so hard, that made the eye dry, even using the eye solution (artificial tears drops) many times a day did not help to save the dog`s eyes and led to the cloudiness and later to the the blindness. It is not the technique to blame for,  but the horrible work the ophthalmologist has prepared on the dog.
   Well, since we have no data on the Neapolitan Mastiff cherry eye correction besides the gland removing for so long, where the majority of the mastini have different ocular problems or/and becoming blind at the very early age, how could we assume that the removing the gland is the best option to deal with the Harder`s gland, how could we guess the number of the dogs who would not have developed the blindness or other  ocular issues if the gland would be preserved?
   Let`s try honestly to view the whole picture of why the Neapolitan Mastiff breeders recommend to remove the gland, without the consideration of moving towards the another progressive advanced option of the preserving it as the needed back-up tear resource, while the breed has probably the worst health issues increasingly growing in % and numbers (autoimmune disorders, thyroid and all the possible existing ocular problems)?
    First and the most prevailing point is because it is costly at first place and there is still a possibility that the gland correction might fail, then will have to re-do it later paying again and more likely remove it, then why to try? Second, there is no guarantee that the specialist is experienced and will prepare a good professional work which will preserve the gland the correct way to be held in the place. Third, the Neapolitan Mastiff breed has been affected with another serious ophthalmologic issues (entropion, ectropion, dermoid, atrophy, etc. and still are the active breeding stock), that the cherry eye is not much to consider or paying the attention to.
   Trying to make a point here not only on the small facts, but considerably..., first of all, not a secret that every dog is individual,  and can be really different from the others on the health issues; do not forget that each specimen shall be treated with the individual approach - choosing and performing the best possible procedure to correct it, which in future will help the dog to be capable to see or make the pet blind. I wish that the Neapolitan Mastiff owners were more responsible for making the right decision on what to do, and how to correct, not being selfish and influenced by the most "suitable" (shall i say cheaper) for the owner option, not thinking about how it will affect the pet`s eyesight in future (when the neo is around 2-3 years old).
   I am not trying to advocate or stout the only one solution to the issue, all the methods work on my dogs so far (earlier I was used to remove the glands, recently we started the cherry eye correction (preserving it)), but note all the dogs I mentioned here have no any disorders or other health issues, it might not work if they did, so it would be good enough for the breeders and people in the breed to start thinking a bit progressively on the choices to be made about the dog.
   The cherry eye is the issue in the breed but easy to correct, but the big eye problem in the breed is
entropion when eyelashes rolled inside in the eye, irritate the eye cornea, hurting and destroying eyes, leading to the blindness. If the breeders would really watch out for the health problems, eye OFFA certify their Neapolitan Mastiffs excluding the specimens from the breeding stock who have such serious issues as entropion and dermoid, the breed would be much healthier in ocular issues than it is now, when we have the entropion almost in each specimen, and starting "to introduce" it as the norm for the breed. Pity, but getting the way too out of control in the real numbers.
   The Neapolitan Mastiff has the worst position in the molosser breeds (shall i say in the canine world) for the eyes, it is a shame that we almost do not have dogs eye-certified, how could we, if our dogs are whether gone at the very early age or blind after 2-3 year old. Could we ever approve on the eye issues if we breed two specimens with the horrible entropion, knowing that all the offsprings will suffer from the same problem all their lives from the day 1.
   Please, if you love the breed, if you care for it`s future, do not forget about the responsibility for what you do today! "Closing your eyes" on the problem does not make it disapear, does not resolve it on it`s own, but increases the number of suffering dogs in the breed.
pup eye
neo eyes
dog cherry
mastino cherry eyes
Please click on the icon to see in bigger size a Neapolitan Mastiff puppies (blue and tawny) with the cherry eye shown.
Neapolitan cherry eye
hardian gland
Please click on the pictures to see in bigger size. (left) Blue 2,8 yo old Neapolitan Mastiff male and (right) Black 3 years old Neapolitan Mastiff female who have never had a cherry eye prolapse
no prolapse third gland
Please click on the icon photo to see in bigger size. Here are pictured of the Neapolitan Mastiff puppy who has had a cherry eye correction (orbital) prepared on (tacking and stitched around) , did not work for her.
The article above was written by Natalia Means Wild Child Neapolitan Mastiff kennels.
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Gelatt Lea & Febiger., Veterinary Ophthalmology. Malvern, PA; 1991
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Esther Van Praag, PH D Prolapse Of The Harderian Gland Or Cherry Eye.