My older boy had it popping out when he was a pup. It never got inflamed, always went back in without problems and by he time he was about a year and a half old it stayed in. My younger boy's gland got infected, it didn't stay in anymore and when that happens it's time for surgery. You can tell the difference for sure. When it's infected it does almost look like a ripe cherry. If it's pink and goes in I don't recommend surgery. His other eye popped out an occasion too, but it was enough to just put some lubrication in his eye and keep his head tilted back for a while. Now they're both big boys and no cherry eyes.