2020 Update:
Hello all,
It has been awhile since I first started this thread. I didn't update it for the longest time because everywhere I went, I was getting nowhere with vets. So here's the story so far. It's a long one!
October 2018 Vet #1
After initially posting we went to an exotic vet. She thought it looked to be a cataract, which has any number of causes, and was not worried about an ulcer, infection or anything dangerous. We left with a "wait and watch" plan.
November 2018 Vet#2
We took him to see an eye specialist/ophthalmologist. The eye had changed by this point with the cloud becoming grey, no longer green, and looking very murky instead of a clearly defined circle. This was difficult to photograph but I find it very odd that it went from such a clearly defined green circle to faint streaky grey clouds. The ophthalmologist did a pressure test to check for glaucoma but the pressure was the same in both eyes. He also diagnosed a cataract and said it was nothing to worry about. By this point I noticed he would squint this eye or keep it closed more often than the other eye so it appeared to bother him. He was prescribed once daily diclofenac drops in his eye for pain.
Early 2019 Vet #3
I notice the eye appears to be getting larger than the other one. I take him to a different reptile vet who did not think it was any larger and says the same things: cataract with nothing to worry about. Keep doing the eye drops if it appears to bother him.
September 2019 Vet #4
I am convinced the right eye is larger, at least the tissue surrounding it or SOMETHING is larger. I took this photo to try and demonstrate that and you can see how the right eyelid area (the one on the left of the photo) appears fuller and rounder while the healthy eye is more diagonal. I take him to a different ophthalmologist who says the eye does not appear larger but maybe the eyelid or surrounding tissue is inflamed. He also thinks it's a cataract likely due to trauma or potentially just genetic/a birth defect. He does an eye pressure test which comes back normal. He prescribes 2x daily ketorolac eye drops for pain. By this point he appears to be blind in this eye.
February 2020
Ecco goes in for a yearly checkup and the vet (#3) says he CLEARLY has a mass behind his eye and he would like to remove the eye and the mass. He did not want to do diagnostic testing as he said it was inaccurate on such small animals. I am uncomfortable with this and decide to get a second opinion. His pupil is now completely grey and almost has flecks in it, like mica or granite. The pupil does not dilate when exposed to light and the eye is dropped permanently in a down and back position, showing the "white" of his eye around the iris.
March 2020
We go back to vet #4/opthalmologist #2 to get a second opinion. He says there is nothing that indicates a mass to him and suggests we could do an MRI. We instead opt for a CT scan as MRI's are not effective on reptiles as they rely on water content. The use iodine as a contrast. The results were that his right eye, the blind one, is 2 millimeters larger in diameter than the healthy eye. There were no signs of a mass around eye/the eye socket appeared normal. Here are some possibilities:
1. Glaucoma. He somehow developed a cataract, which could have caused irritation in the eye, causing swelling, which caused pressure, which forced the eye to grow. His last pressure test still had low pressure which did not indicate glaucoma but the pressure in the right eye was slightly higher by I think 1 or 2 points.
2. A mass IN the eye. The CT was not able to get a clear picture of the pupil/lens. This could be due to a cataract or the cataract leaking outside of it's pocket, which could be obscuring a mass within the eye. But he said it does not look like a mass, but it's possible there is one in the eye that is causing the eye to grow as the mass grows.
3. Who even knows, it's weird.
We left with again just waiting and watching.
Mid 2020 Vet #5
Me being the paranoid pet parent that I am, we went to see one last person. He thought that at some point Ecco may have luxated his lens, which is when the lens gets tilted in the eye. This can cause the fluids in the eye to build pressure as it changes how fluids flow around the lens. The swelling and inflammation caused scar tissue, which is why his pupil is rigid and does not respond to light. He suspects that over time the eye will begin to shrink as the scaring increases. He suggested stopping the eye drops if they weren't helping, and by this point Ecco keeps that eye closed for 90% of the time so it seems as if they aren't helping. He noted that since Ecco is ADV positive, it's very possible that the ADV is just messing up otherwise healthy parts of him. He suspects that overall he will live a shorter life but noted that he looked in great condition besides the eye. We did bloodwork to rule out any latent/long term infection and everything came back normal (his CK/creatine kinase was very high at 3658 but that can easily be triggered by stress and that appointment was particularly long as the vet was very behind and Ecco had been stressing with three car trips within two days so I suspect it was just that).
September 2020
Here we are now almost two years later. Ecco still seems to be doing well besides the eye. He still eats with enthusiasm. But he has been grumpier the past year and is overall a bit lethargic and dark. And particularly the last few days he does not open the eye. His eyelid area looks very inflamed to me and it's clear it bothers him. I don't know how to help him and I'm upset that this ever happened especially since we don't know why or even what it is. There is still the possibility of a mass within the eye but I'm not keen on removing the eye since that really puts his life at risk going under for surgery. And there's no guarantee that would take the pain away as I'm sure having a hole in your head comes with it's own complications. Has anyone ever seen anything like this? 5 different vets and crazy expensive tests have not helped us. I know he will never regain his sight, and that's fine as he functions pretty well without it, but I don't want him to be in pain.