Melissa cares for a variety of exotic animals and has completed a certificate in veterinary assisting and a bachelor's degree in biology.
Eye issues in captive leopard geckos are unfortunately very common. Pet owners may observe that their leopard gecko is closing their eye more often, has discharge present around the eye, or may even act like they are blind. These problems can range from common and treatable at home to very serious, and seeking treatment from an exotic animal vet may become mandatory.
Why Are Leopard Geckos Prone to Eye Issues?
Leopard geckos are nocturnal lizards in the family Eublepharidae. While they are native to the desert regions of Pakistan, India, and Afghanistan, they prefer to shelter in cooler, damp, underground burrows in the wild.
Leopard geckos are unique in that they possess true moveable eyelids that are "crinkled"  and not spectacle . Therefore, these popular lizards have specific requirements for the right amount of humidity to properly shed the region around their eyes.
In addition, as their nutritional requirements are not well understood, nutritional deficiencies may play an important role in their ocular health, as well as their overall wellness.
Hypovitaminosis A (Vitamin A Deficiency)
There is a limited amount of evidence that points to vitamin A deficiency, which is common in insectivorous reptiles  as a significant contributor to eye problems in leopard geckos. Many of the health problems listed below may be influenced by this dietary complication. Unfortunately, not much is known of how much, if any, vitamin A supplementation should be administered, and there is a risk of causing a toxic amount of vitamin A to occur, known as hypervitaminosis A .
It is safest to feed a varied diet of gut-loaded insects (15+ species) to leopard geckos, especially silkworms and small frozen/thawed pinkie mice to adults (feed sparingly) , which are commonly available and are high in vitamin A.
The gut load for the insects should be varied as well, including a variety of fruits, vegetables, grains, and flaked fish food  . Supplementing for vitamin A remains controversial . Other options include multivitamins that contain Vitamin A . Beta carotene supplements are not recommended because it is not taken up by reptiles as a source of vitamin A .
Common Symptoms of Eye Issues in Leopard Geckos
Eyes “glued” shut or not opening eyes
Eye swelling and blepharedema (swollen eyelids)
Rubbing the eyes
Pus in or around the eye
Blepharospasm (eye twitching)
Eye mucus, “goo,” discharge, or crust in or around the eye
Partial or full blindness
When to See a Vet
Ideally, in a perfect world, you should always see a vet if you have concerns about your pet’s health, particularly when there are issues involving the eye, which is obviously a sensitive part of the body that can easily become damaged with improper or delayed intervention.
However, veterinary care for these small lizards can be relatively expensive, and many don’t have access to vets with the proper reptile experience, if they will even see a reptile.
Some eye problems in geckos can be addressed with mild over-the-counter solutions, although getting a vet’s assistance with a free service such as various Facebook groups that have volunteers who are vets is strongly encouraged. However, if your reptile is also experiencing lethargy and anorexia, their condition could potentially be fatal .
List of Eye Problems in Leopard Geckos
It should be noted that when leopard geckos and other reptiles have eye issues, there may be other more severe nutritional or systemic issues going on, including organ dysfunction  or respiratory infection .
Simply cleaning the eye out may not resolve your pet's problem, and sometimes what may appear to be a matter of a foreign body in the eye could be something more serious, or there can be damage to the eye that requires veterinary intervention.
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There can even be some diseases that mimic eye problems by causing the eyes to bulge due to other reasons . The following list may help guide pet owners towards what issues their leopard could have, but it is not a substitute for bringing your pet in to be examined.
Retained Shed/Eyelid Impaction
Leopard geckos that have difficult shedding (dysecdysis) are more likely to have problems with their eyes . Such geckos can be identified by the presence of incomplete shedding pieces on the head region.
Commonly, leopard geckos may retain the skin of the inner eyelid lining or have an accumulation of keratin in the conjunctival sac , and continual occurrence of this may lead to impaction or hyperkeratosis of the eye, which is the formation of a "plug" composed of the dead skin . Unfortunately, retained shed can get so severe it can cause leopard geckos to stop eating . Untreated, this condition can cause the cornea to fuse with the plug, causing permanent eye damage .
In the early stages, this problem could potentially be resolved by the owner using a q-tip or other soft, blunt object , delicately rolling the eyelid upward and flushing the eye until the skin dislodges such as in the video above. The eye can be lubricated with preservative-free sterile saline (products for contact lenses should work , commercial reptile eye drops, or even filtered water. Do not force the product into the eye and do not continue if the object does not come off easily .
To further prevent the problem, be sure to provide your gecko with a humid hiding spot by lining an enclosed shelter (this can be a plastic food storage container) with moist peat, vermiculite, or sphagnum moss . One exotic veterinarian believes that temperatures that are too high cause poor humidity, and that the geckos should be soaked twice a week in knee-deep warm water .
Debris/Foreign Body in the Eye
The occurrence of a foreign body in the eye is usually linked to loose substrate such as sand , which is generally recommended against due to other issues involving impaction, as well as potentially causing eye issues due to its dustiness and particle size that can get lodged in the eyelid .
Sometimes this debris can be flushed out of the eye with saline  or other eyewashes, but resulting ulceration or abrasion would need to be treated by a vet .
Infections: Viral, Fungal, Bacterial
Infections in reptiles can result from penetrating injury and foreign bodies, which may cause the eye to become enlarged or shrink (phthisis bulbi) . Organisms like Pseudomonas have been found in the eyes of leopard geckos .
One case study detailed the discovery of fungal keratitis caused by the fungi Acremonium sp. and Trichosporon sp. in a leopard gecko and antifungal medication improved its ocular health where vitamin A and antibiotic therapy did not .
Infection of the conjunctiva most likely results from secondary infection from opportunistic organisms. It is notable that a symptom of conjunctivitis is the closure of the eyelids and accumulation of discharge causing a bulging of the eyelid .
Keratoconjunctivitis involves the cornea and the conjunctiva and is more likely to be a result of inadequate hygiene . It is important to consider that long term infection may result in loss of the eye due to septicemia .
This is a form of inflammation of the cornea—the outer layer of the front of the eye— that does not retain fluorescein stain, which is used to identify ulcers. This indicates that the cornea has not been damaged . This is a relatively common finding with leopard geckos that see the vet for eye problems .
Corneal Ulcer/Ulcerative Keratitis
Ulceration may occur due to trauma, foreign bodies, and prolonged infection . This condition requires veterinary intervention.
It is not unusual for reptiles to injure their eyelids  due to a scratch, bite, or abrasion, which can cause infection . In severe cases, some damaged eyelids may require surgical closure .
Leopard geckos are prone to subcutaneous abscesses  and can sometimes get them around their eye region, which may present as a small bump with debris collecting under the eye. Trauma or system infection can cause this condition. They require surgery for removal .
Sometimes abscesses are associated with Gram-bacterial isolates, making them difficult to manage . It should be noted that in some cases of vitamin A deficiency, conjunctivitis may result in a pseudo abscess .
In probably rare cases, eye issues can be caused by parasites, as one veterinarian has described observing thin worms in the conjunctival sac of the eye .
Uveitis may result from trauma, infection, or may be associated with neoplasia . It is rarely diagnosed in reptiles .
Genetic Defects of the Eye
Sometimes reptiles are born with congenital eye abnormalities such as microphthalmia, which may occur as a consequence of inbreeding , as well as other genetic abnormalities including cyclopia and anophthalmos .
Congenitally deformed eyelids have been found in leopard geckos which can lead to ulceration and infection . Another leopard gecko with fused eyelids since birth was found to have congenital ankyloblepharon that was corrected with surgery .
Furthermore, if your gecko is albino or a lighter colored morph, it may be sensitive to bright lights .
Neoplasia is frequently reported in reptiles  and may be caused by viral infections . Neoplasms consist of fibropapillomas, fibrosarcomas, fibromas, papillomas  which may or may not be cancerous. No primary ocular tumors were found in reptiles and only a few periocular tumors have been reported .
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This article is accurate and true to the best of the author’s knowledge. It is not meant to substitute for diagnosis, prognosis, treatment, prescription, or formal and individualized advice from a veterinary medical professional. Animals exhibiting signs and symptoms of distress should be seen by a veterinarian immediately.
© 2020 Melissa A Smith