Fig. 7 The chronic iritis often associated with lepromatous leprosy may result in marked iris atrophy with stromal loss, iris pigment epithelium loss, and frank iris holes. This severe iris atrophy is symptomatic of long-standing disease. Although the cause is unknown, Mycobacterium leprae bacilli seem to affect preferentially the nonmyelinated iris nerves with a “neurotrophic” iritis and iris atrophy.