Leopard geckos are seen at veterinary clinics for an assortment of eye issues because their eyes unfortunately seem to get things stuck in them, abscess, get infections, and have other issues more commonly than we do with our own eyes. Many of these eye issues can be attributed to husbandry and environmental factors that we control though. Therefore, it is important to be able to recognize a possible issue before it is too late to help the eyes.
Leopard Gecko Eye Foreign Bodies
This is what your exotics vet will call something in your leopard gecko's eye that shouldn't be there, such as a piece of gravel or bedding, food, retained skin, or something else that doesn't belong around an eye ball. These items basically get stuck or lodged in the eye socket causing issues.
By using cotton tipped applicators (Q-tips©), saline rinse, and sometimes even some eye lubrication, your vet should be able to remove the irritant from the affected eye. Occasionally the foreign body is so difficult to remove or the leopard gecko won't open their eye up enough to remove what doesn't belong that some light sedation, or anesthesia, is administered. This will relax your gecko and allow your vet to work more quickly and not damage the eye.
If you attempt to remove an item from your leopard gecko's eye, be very gentle. Try rinsing the eye with saline eye rinse while gently restraining your gecko. You can even gently swab the eye with a cotton tipped applicator or cotton ball but be careful not to hurt your gecko or stress them enough to cause them to drop their tail.
Leopard Gecko Eye Abscesses
The eye itself can be punctured, become infected and abscess but more commonly the area directly under the eye swells up and abscesses due to a wound that doesn't involve the eye. You may notice a bump under your leopard gecko's eye that has just suddenly appeared one day. This could be attributed to a cricket or mealworm bite, or he could have scratched himself in his cage. Sometimes geckos that live together can also fight and cause abscesses on each other.
Regardless of the reason for the abscessation, your leopard gecko will need the abscess to be lanced (popped) by your vet and cleaned out. This will allow it to drain and remove the infection. The vet may use a scalpel blade or a needle to lance it (pop it) and then gently squeeze the pus out of the abscess (much like you would pop a zit). Then, depending on how bad the area around the eye is, your vet may send you home with eye drops, pain medications, and antibiotics.
Leopard Gecko Eye Ulcers
When something gets stuck in your gecko's eye (a foreign body), such as bedding, or other trauma occurs to the eyeball itself, damage to the cornea (the clear, outer coating of the eye) may happen and an ulcer can result. An ulcer is basically a hole in the cornea and it can be just a small spot on the eye or cover the entire eyeball.
Ulcers, as you can imagine, are a very painful eye issue. Your gecko may be holding his eye shut, try to clean it with his tongue, or be scratching it with his tiny foot. To diagnose an ulcer your exotics vet will use a special eye stain that will stick to the ulcer on the eye if there is one. Then they will use a black light to cause the stain to light up on the ulcer so that they can see it. If an ulcer is found you will be sent home with special eye drops and your gecko will need to be rechecked in a few weeks to make sure the ulcer is going away. There are unfortunately no home remedies for an eye ulcer.
Leopard Gecko Pink Eye
Conjunctivitis is the technical name for pink eye and is the inflammation of the pink part that surrounds your leopard gecko's eye. This pink to red, fleshy part of the eye is called the conjunctiva. Leopard gecko eyes usually get bacterial conjunctivitis and require an antibiotic eye drop or ointment. They can get this conjunctivitis from dirty water or any environment that would harbor bacteria (i.e. a dirty cage).
Leopard Gecko Eye Proptosis
This is probably the worst type of eye issue and thankfully the least commonly seen one in leopard gecko eyes. Proptosis is when the eyeball pops out of your leopard gecko's head. Really the only way this would ever happen is if your gecko gets squeezed so hard that his eye comes out. The eye usually has to be removed, as it will be hanging from the optic nerve, but sometimes it can be surgically replaced.
Leopard Gecko Blindness
Sometimes leopard geckos are born blind due to congenital issues and other times trauma or other situations cause blindness. Regardless of the reason for being blind, leopard geckos should do just fine without their sight. You may need to help them eat since they could have a difficult time catching moving food, but otherwise they will live out their lives in a regular enclosure just fine.