An old man with a systemic disease is found to have 'iris pearls' during ophthalmologic evaluation. This man is likely to suffer:

Ocular leprosy: The early clinical signs of ocular leprosy are, Lagophthalmos Loss of the lateral poions of the eyebrows and eyelashes (madarosis) Conjunctival hyperemia Superficial keratitis Interstitial keratitis--beginning typically in the superior temporal quadrant of the cornea--often supervening. Granulomatous iritis with lepromas (iris pearls) is common, and a low-grade iritis associated with iris atrophy and a pinpoint pupil may also occur. Hyperophy of the eyebrows with deformities of the lids and trichiasis late in the course of the disease. Exposure keratitis, typically in the inferior and central cornea, can result from facial motor nerve palsy and absence of corneal sensation. Ref: Pringle E., Graham E.M. (2011). Chapter 15. Ocular Disorders Associated with Systemic Diseases. In P. Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e.