This week I saw a leopard gecko named Lizzy. Her owner took her in and got her a big cage and a warm light and offered her lots of mealworms and crickets.

Everything seemed to be going well until last month when her eyes began to look a little funny. Her toes also had some dead skin sticking to them from her last shed. Recently she has begun to just sit around and refuse food.

When I saw Lizzy here in the clinic, she was alert and still in good body condition. There were two major findings on Lizzy's examination.

First was that she has a small amount of retained shed around her toes. I have seen this many times before in leopard geckos. When their shed skin comes off, it gets trapped around the toes. They are usually able to pull the larger pieces off themselves, but small rings of dead skin can remain in place. I have even seen these act like tourniquets over time and cause the toes to fall off. I can only imagine how painful that experience must be. Lizzy's toes were in good shape still.

The most prominent feature to Lizzy's physical exam was that her eyes appeared to be hard and crusted. This presentation is quite common in leopard geckos, and what we were actually looking at was bilateral plugs of retained skin stuck to the lids and covering the surface of the eyes.

To remove the eye plugs, I lubricated the eyes with an ophthalmic ointment and waited. After sufficient time had passed, I used a fine tipped blunt tool to gently peel the dead skin away. This is a nerve-wracking procedure. I have, luckily, never damaged an animal's cornea during this process, but I have heard many reports of that happening. Whenever I undertake this procedure, I move very slowly and cautiously.

There have been several occasions when the plug was attached too tight and I had to stop. In these cases I have asked the owners lubricated the eyes regularly for several days before trying again.

Luckily, Lizzy's eye plugs came off fairly easily. Underneath, the surface of her eye was intact, though irritated from being covered up with crusts for so long.

So, why did Lizzy's shed stick to her eyes and her toes and cause so much trouble for her? The answer is 100 percent about her environment. She is most likely suffering from a lack of vitamin A and possibly from improper temperature gradients.

When keeping any reptile, getting their husbandry just right is the most important thing you can do for them. This includes making sure that they have proper temperature gradients, good bathing opportunities, the right humidity, proper objects to hide in and rest on, the right type of lighting and great nutrition.

The best way to make sure you are getting the right temperatures is to get a probe that you can place in the very spot where your pet spends its time. The thermometers that are on the side of the tank can be five or more degrees different from the temperature where your pet actually hangs out. Though this doesn't seem that impressive to us, it is important to remember that reptiles depend on their environment to change their body temperature. If they can't get into the temperature zones that they need in their environments, they can suffer from profound overheating or hypothermia.

Adult leopard gecko diets should consist of mostly crickets. They should be fed every two to four days. The crickets should be dusted with a calcium/vitamin D3 supplement two times per week and with a multivitamin every other week.

For leopard geckos, it is extremely important to use a multivitamin that has PRE-FORMED VITAMIN A in it. Many multivitamins have Beta Carotene in them, which many animal can convert to vitamin A in their bodies. Leopard geckos cannot do this. So, if they aren't getting the vitamin A they need, they end up with a variety of problems.

Also, it is important to train your leopard gecko to eat right away and then remove the excess crickets. After about 30 minutes, crickets manage to groom almost all of the vitamins and minerals off themselves.

Caring for reptiles can be difficult, but getting it right is important. Lizzy's owner is like a lot of people. She ended up with a gecko and tried her best to care for it without realizing just how exact some of her requirements are.

We have adjusted the temperatures in Lizzy's enclosure, started dusting her food with a multivitamin containing preformed vitamin A and started soaking her in lukewarm water baths to aid in her hydration. We still have to get her eating, but we're optimistic that being able to see again will be a great first step.

All my best wishes to Lizzy and thank you very much to Lizzy's owner for sharing her story.

Lyssa Alexander, DVM treats small and exotic animals and pocket pets at All Creatures Animal Clinic.