Moth-Eaten Appearance of the Iris in Hansen Disease.

A woman in her early 60s treated for Hansen disease 20 years ago presented with diminution of vision in both eyes for the past year. Her best-corrected visual acuity was 6/24 OU. A moth-eaten pattern of iris atrophy was noted bilaterally. Iris atrophy has been reported to be the most common ocular lesion in chronic multibacillary leprosy (25% of patients), persisting despite adequate treatment (3% of patients). The patient’s lens showed cataractous changes in both eyes with a normal posterior segment as evidenced on B-scan ultrasonography. Corneal sensation measured with a Cochet-Bonne esthesiometer was 55 mm OD and 50 mm OS (mean [SD] normal sensation, 57.50 [3.41] mm). Clinical images (slitlamp and near-infrared autofluorescence photographs) showed a moth-eaten appearance of the iris in a case of resolved chronic bilateral anterior uveitis with decreased corneal sensation, which is probably a sequela of Hansen disease.