Third Eyelids Problems in Cats

The third eyelid is not normally seen, but it may become opaque and/or visible in response to illness or injury. A few cats will have their third eyelid up when they are totally relaxed and resting, so it is important to know what is normal for your cat. In these cats, the membrane will retract quickly when they alert or startle, and then stay retracted for awhile. The length of time the membrane is exposed may vary, as though the cat is blinking, or it may remain visible. When the nictitating membrane is visible over the inside corner of the eye, it is protruding.

When associated with a bulging eye, causes of protrusion of the nictitating membrane include infection in the tissue behind the eyeball (abscess), bleeding behind the eye (hematoma), and tumor.

When associated with a retracted or sunken eye, causes of protrusion of the nictitating membrane include any painful eye illness resulting in spasm of the muscles around the eye; spasm of these muscles when caused by tetanus; and dehydration or chronic weight loss that reduces the size of the fat pad behind the eye. When only one eye is involved, suspect an illness related to that eye; when both eyes are involved, suspect a systemic illness such as feline viral respiratory infection.

Horner's Syndrome

Horner's syndrome can result in a sunken eye, prolapse of the third eyelid, and a small pupil. This can occur as a consequence of injury to (or cancerous involvement of) a nerve in the neck or a middle ear infection.

Treatment: There is no treatment, although the condition may resolve with time.

Haw Syndrome

This is a rather common but temporary protrusion of uncertain cause of the third eyelid. It affects otherwise healthy cats under age 2 and is frequently preceded by a gastrointestinal illness.

Treatment: The protrusion clears up within a few months without treatment. During this time, if the film interferes with your cat's vision, your veterinarian can prescribe an eyedrop solution containing 1 or 2 percent Pilocarpine, which reduces the size of the protrusion.

Cherry Eye

Eversion of the gland of the nictitans, known as cherry eye, occurs in cats, especially the Burmese breed. For unknown reasons, the cartilage of the third eyelid folds over, everting the gland. This condition is not only unsightly but can be uncomfortable and may cause corneal ulceration in the cat.

Treatment: At one time, eversions of the nictitans gland were treated by surgical removal, but that is not the ideal solution. Since part or all of the gland was usually removed at the same time, there was decreased tear production. This often led to secondary keratoconjunctivitis sicca. Now the gland is generally repositioned surgically.

This article is excerpted from “ Cat Owner’s Home Veterinary Handbook” with permission from Wiley Publishing, Inc.